Infection in diabetic patient in emergency

This retrospective study was conducted to evaluate the place of infection in diabetic ketoacidosis in an emergency unit. It included 214 patients who were admitted for ketoacidosis and in whom an infection was identified. The infection was present in almost all patients and it seemed to be the direct cause of decompensation in 41%. The diagnosis was made on the clinical signs and the biological evaluation. On the 112 urinalysis performed, 45 were positive and on the 43 hemocultures, 9 were positive. An empirical antibiotherapy was started on admission in 88 cases. Thirty four patients had a severe sepsis of whom 21 developed a septic shock and 13 [6%] were transferred to the Intensive Care Unit; 4 patients died [1.9%]. We found a strong correlation between the initial presence of infection and the occurrence of at least one organ dysfunction [p=0.0001]

[Cerebral toxoplasmosis revealing a neuro-Aids]

Cerebral infection to toxoplasmosis is an opportunist infection. Its radiological aspect is not specific. It concernes male patient of 38 years old, treated from Crohn disease since three months, who was presented by infectious intracranial hypertension syndrome, symptomatic treatment was prescribed. In front his clinical aggravation, a multiple intracranial MRI was done, which showed a miliary encephalitis. Tubercolous origin was thought of and the patient received an anti-tubercolous treatment. Secondary, stereotaxic biopsy and biological study showed an advanced stage of toxoplasmosis infection reveals to a neuro-Aids. Through this observation, the authors paid an attention to think always in the eventuality of neuro-Aids in front of cases of miliary encephalitis