Late Controlled Type 2 Diabetes Mellitus with Severe Acute Systemic Infection

Background: The last International Diabetes Federation statement showed that in 2015, there were 415 million people diagnosed with diabetes and the expectation for 2040 is around 642 million people all over the world. Diabetes Mellitus is a disease associated with major negative consequences due to its acute and chronic complications with chronic hyperglycemia playing a major role.

Method: We are presenting a case of 52 year old male patient, known with Type 2 Diabetes Mellitus for 10 years without treatment due to personal decision, who was admitted through the Emergency Unit in Neurology Department for bilateral myalgia of hips and arms, proximal force deficiency of bilateral lower limbs, acute retention of urine, fever, simptomatology which started about 48 before admission. The suspected diagnosis was acute polyradiculoneuritis but the paraclinical investigations performed on Neurology Unit excluded it and evaluated the present disease as Acute Diabetic Neuropathy. Through the passing days, the patient developed paraplegia and major unbalanced glycemic control (although he received multiple rapid human subcutaneous insulin injection) so they’ve decided to transfer him into Diabetology Department. At the moment of admission into Diabetology Unit, the patient had high fever, superficial and deep sensitivity disorders, urethral catheter and no faeces for 7 days. We’ve continued our investigations and came with a positive diagnosis of Unballanced and Complicated Type 2 Diabetes Mellitus with insulin therapy, Parainfectious Acute Transverse Myelitis, Prostatic and Seminal Vesicles Abces with rectal fistula, Sepsis, Acute Retention of Urine, Urina Infection with Pseudomonas Aeruginosa.

Conclusion: The diagnosis of Unballanced Diabetes Mellitus involves differential diagnosis due to lack of specific simptomatology in Diabetic Neuropathy and associated immune deficiency.