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Hypoglycemia in bacterial septicemia

Published online by Cambridge University Press:  21 May 2015

Ian Preyra  and
Andrew Worster
Ian Preyra
Affiliation:
Division of Emergency Medicine Hamilton Health Sciences and McMaster University, Hamilton, Ont.
Andrew Worster*
Affiliation:
Division of Emergency Medicine Hamilton Health Sciences and McMaster University, Hamilton, Ont.
*
Division of Emergency Medicine, Hamilton Health Sciences, 237 Barton St. E, Hamilton ON L8N 3Z5; 905 527-4322 x46997, fax 905 527-7051, [email protected]

Abstract

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In the emergency department (ED), the typical manifestation of impaired glucose homeostasis seen in patients with severe bacterial infections is hyperglycemia. Severe hypoglycemia is generally not a presenting feature of sepsis in children in the emergency setting, and thus may lead to delayed diagnosis and management. We present a case of a 14-year-old boy who attended the ED with constitutional symptoms and severe hypoglycemia as the initial presentation of overwhelming meningococcal sepsis and discuss the impairment of glucose homeostasis in patients with sepsis.

Keywords

hypoglycemiasepticemiameningococcal sepsisacute presentationsemergency medicine
Type
Case Report • Observations de Cas
Information
Canadian Journal of Emergency Medicine , Volume 5 , Issue 4 , July 2003 , pp. 268 - 270
Copyright
Copyright © Canadian Association of Emergency Physicians 2003

References

1.Maitra, SR, Wojnar, MM, Lang, CH.Alterations in tissue glucose uptake during the hyperglycemic and hypoglycemic phases of sepsis. Shock 2000;13(5):379–85.CrossRefGoogle ScholarPubMed
2.Salzman, MB, Rubin, LG.Meningococcemia. Infect Dis Clin North Am 1996;10(4):709–25.CrossRefGoogle ScholarPubMed
3.Rimar, JM, Fox, L, Goschke, B.Fulminant meningococcemia in children. Heart Lung 1985;14(4):385–91.Google ScholarPubMed
4.Ferguson, LE, Hormann, MD, Parks, DK, Yetman, RJ.Neisseria meningitidis: presentation, treatment, and prevention. J Pediatr Health Care 2002;16(3):119–24.Google Scholar
5.Leclerc, F, Leteurtre, S, Cremer, R, Fourier, C, Sadik, A.Do new strategies in meningococcemia produce better outcomes? Crit Care Med 2000;28(9 suppl):S60–3.CrossRefGoogle ScholarPubMed
6.Havens, PL, Garland, JS, Brook, MM, Dewitz, BA, Stremski, ES, Troshynski, TJ.Trends in mortality in children hospitalized with meningococcal infections, 1957 to 1987. Pediatr Infect Dis J 1989;8(1):8–11.CrossRefGoogle ScholarPubMed
7.Garty, BZ, Nitzan, M, Danon, YL.Systemic meningococcal infections in patients with acquired complement deficiency. Pediatr Allergy Immunol 1993;4(1):6–9.CrossRefGoogle ScholarPubMed
8.Ellison, RT 3rd, Kohler, PF, Curd, JG, Judson, FN, Reller, LB.Prevalence of congenital or acquired complement deficiency in patients with sporadic meningocococcal disease. N Engl J Med 1983;308(16):913–6.Google Scholar
9.Mizock, BA.Alterations in carbohydrate metabolism during stress: a review of the literature. Am J Med 1995;98(1):75–84.Google Scholar
10.Miller, SI, Wallace, RJ Jr, Musher, DM, Septimus, EJ, Kohl, S, Baughn, RE.Hypoglycemia as a manifestation of sepsis. Am J Med 1980;68(5):649–54.CrossRefGoogle ScholarPubMed
11.Schumer, W.Metabolism during shock and sepsis. Heart Lung 1976;5(3):416–21.Google Scholar
12.Imamura, M, Clowes, GH Jr, Blackburn, GL, O’Donnell, TF Jr, Trerice, M, Bhimjee, Y, Ryan, NT.Liver metabolism and glucogenesis in trauma and sepsis. Surgery 1975;77(6):868–80.Google ScholarPubMed
13.Romijn, JA, Godfried, MH, Wortel, C, Sauerwein, HP.Hypoglycemia, hormones and cytokines in fatal meningococcal septicemia. J Endocrinol Invest 1990;13(9):743–7.CrossRefGoogle ScholarPubMed
14.Jacobs, RF, Tabor, DR.The immunology of sepsis and meningitis-cytokine biology. Scand J Infect Dis Suppl 1990;73:7–15.Google ScholarPubMed
15.Girardin, E, Grau, GE, Dayer, JM, Roux-Lombard, P, Lambert, PH.Tumor necrosis factor and interleukin-1 in the serum of children with severe infectious purpura. N Engl J Med 1988;319(7):397–400.CrossRefGoogle ScholarPubMed