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Diabetic ketoacidosis and disseminated strongyloidiasis resulting in Gram negative sepsis and empyema thoracis from enterobacteriaceae.
The filariform larva of Strongyloides stercoralis, an intestinal nematode seen in tropical and subtropical countries.
Various conditions predisposing to disseminated strongyloidiasis are given in box 1
.
Some cases may have no identifiable risk factor for immunodeficiency.
The patient developed moderately severe diabetic ketoacidosis because of sepsis and the omission of insulin injections. The severity of ketoacidosis had been assessed to optimise the management and monitoring of the patient.1 Diabetes mellitus is a predisposing factor for the dissemination of Strongyloides stercoralis infection,2 the manifestations of which include ARDS, pleural effusions, ascites, haemorrhagic colitis, and meningitis. The invasion of the gut by the parasite predisposes to Gram
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EISSN 1469-0756
ISSN 0032-5473
© 2006 BMJ Publishing Group Ltd and The Fellowship of Postgraduate Medicine.
