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KMID : 0927720080090040341
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Korean Clinical Diabetes
2008 Volume.9 No. 4 p.341 ~ p.345
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A Case of Diabetic Ketoacidosis and Pyonephrosisin Diabetic Patient with Asymptomatic Bacteriuria
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Lee Sung-Hyuck
Kim Hyo-Jeong
Koo Bo-Kyung
Min Kyung-Wan
Jung Jun-Young
Song Eun-Ju
Lee Seung-Wook
Han Kyung-Ah
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Abstract
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We reported a case of type 2 diabetic woman with asymptomatic bacteriuria who developed pyonephrosis after discontinuation of oral hypoglycemic agents, which resulted in diabetic ketoacidosis and septic shock. Clinical symptoms and signs of patient were improved after urgent decompression of dilated collecting system with drainage of pus. Pyonephrosis is difficult to discriminate from general urinary tract infection (UTI) in the early stage of disease by symptom, sign or laboratory finding. Therefore pyonephrosis is known to be fatal when the diagnosis is delayed. For the present, imaging study is not generally recommended for the diagnosis of uncomplicated urinary tract infection. However this case implicated that patients with diabetes, regardless of their present illness, were highly suspicious for the presence of complicated infection and imaging study might be considered as initial evaluation.
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KEYWORD
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Diabetes, Pyonephrosis
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