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TYPE I DIABETES MELLITUS – DIAGNOSIS BASED ON COMPLICATIONS
We present you an atypical case of type 1 diabetes mellitus at onset, with multiple abscesses, diagnosis confirmed afterwards by laboratory tests. This report is of a 14 year-old girl, who presented with abscesses of thighs, hypogastric and inguinal area. The regular investigations performed pointed out hyperglycemia with glucose in the urine, accompanied by weight loss, polyuria and polydipsia. The abscesses were incised and drained. The pathological signs of the clinical examination were: influenced general status, decreased skin turgor, dry lips, multiple fistulized abcesses of the thighs and hipogastric area, hyperemic pharynx and tonsils. The blood tests revealed hyperglycemia (272 mg/dl), leucocytosis with granulocytosis, thrombocytosis, and increased values of hemoglobin. The clinical and paraclinical data were suggestive for type I diabetes mellitus, complicated with abscesses. The treatment consisted in substitutive treatment with insulin associated with antibiotics, antimycotics, analgesics, antipyretics, endovenous perfusions for rehydration. The evolution of the case was favorable under treatment with insulin, the condition of the cutaneous abscesses improved very much after surgical treatment and administration of antibiotics, but they healed only after the equilibration of diabetes mellitus.
In conclusion, even though in the specialty literature it is reported that there appear multiple cutaneous infections in patients with diabetes mellitus wrong treated, these are rarely diagnosed at the onset of this disorder in children, this fact being probably explained by the acute onset of the disease at this age.
Keywords: diabetes mellitus, child, complications