Management of Sepsis Patient Aggravated by Diabetic Ketoacidosis

Abstract— Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host's response to infection. Sepsis can lead to ketoacidosis in diabetes mellitus patients. A 60 years old male complained of headache, mild fever and painful swallowing since 2 weeks prior to hospital admission. History of diabetes mellitus is unknown. Based on examination, the working diagnosis for the patient was sepsis, suspected periapical abscess, type II diabetes mellitus with diabetic ketoacidosis and decreased consciousness. Initial management of sepsis, insulin, and endotracheal intubation were performed. The patient then was admitted to the ICU. Management of sepsis is very important and should be performed based on 1-hour SSC bundle while performing management of DKA. The patient had periapical abscess which is thought to be the source of sepsis. Sepsis then triggers DKA, and several organ dysfunctions in the form of AKI, DIC, and respiratory distress.