M. Mederos Liriano, K. Hageboeck, M. Colantonio, S. Alawad and J. Thayer (2024). Tipped Over the Edge: A Case of Diabetes Ketoacidosis Precipitated by High-Dose Steroids in the Setting of a Large Peritonsillar Abscess. Cureus, 16(3), e56917. https://doi.org/10.7759/cureus.56917

PubMed 38665732

[Abstract]
Peritonsillar abscess is an infection of tonsillar soft tissue which can spread into additional neck structures leading to symptoms of fever, sore throat, dysphagia, and airway compromise. We describe a case of diabetic ketoacidosis in a patient with a history of uncontrolled type II diabetes mellitus admitted for a peritonsillar abscess who received intravenous steroids for management of the abscess swelling. The patient was treated with an insulin drip, hydration, and electrolyte replacement with a resolution to his anion gap and metabolic acidosis. Diabetic ketoacidosis occurs during increased gluconeogenesis leading to ketosis and metabolic acidosis which can be a life-threatening condition if not quickly recognized and treated. This case highlights the importance of monitoring and treating elevated blood glucose in acutely ill patients receiving steroid therapy.