Unzueta OD, Hernández GMA, Díaz MJE, Corral GJC

Language: Spanish
References: 17
Page: 615-620
PDF size: 336.87 Kb.

ABSTRACT

Rickettsiosis is an infrequent clinical entity in intensive care units in Mexico, its prevalence increases in the northern states of the country, mainly Chihuahua and Sonora. Ticks and lice are considered the main hematophagous vectors causing rickettsiosis in these states, probably associated with the climatological characteristics. The lack of specific signs and/or symptoms in early stages of the disease makes diagnosis and timely treatment difficult, leading to a high mortality rate due to the rapid development of septic shock and subsequent multiple organ dysfunction syndrome. A significant number of patients who develop septic shock present hyperglycemia due to metabolic stress, insulin resistance. The current trend of treatment with sodium-glucose cotransporter type 2 (SGLT-2) inhibitors has been increasing due to their beneficial cardiovascular effects, rarely when associated with metabolic stress states can generate decompensation of the acid-base balance without altering capillary glycemia levels (euglycemic diabetic ketoacidosis). Therefore, treatment should be focused on resolving the triggering process together with the correction of the acid-base balance. We present the case of a female patient in the fifth decade of life with a history of type 2 diabetes mellitus under treatment with (iSGLT-2) and with exposure to domestic animals.

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