Diabetic ketoacidosis (DKA) is a medical emergency which requires prompt management to prevent mortality. Treat- ment is complicated in end stage renal failure (ESRF) patients due to their altered physiology in sugar metabolism and fluid haemodynamics. To date, there are only a few case reports illustrating the presentation and management of DKA in ESRF patients and a definite guideline on treatment of DKA in ESRF is seriously lacking. We report here a case of an ESRF patient on maintenance haemodialysis, who develops DKA due to missed insulin, and outline our successful treatment plan. We hope our reported case report research can further contribute to the knowledge of DKA management in ESRF.
Ochrobactrum anthropi is a rare nosocomial pathogen that is manifesting itself mostly in immunocompromised patients and those with indwelling catheters. Identification of the microorganism is challenging and the ability to survive in aquatic surroundings have made it a clinically significant pathogen. Furthermore, the clinical picture of
O. anthropi infection, is not well described. It may manifest in any form of clinical infections though bacteremia is the most common mode of presentation reported in the limited literature. We report here two cases of O. anthropi bacteremia presenting in an immunocompetent and an immunocompromised host respectively with different clini- cal manifestation and response. In view of the highly variable presentation of O.anthropi, a high index of suspicion must be given to at risks patients to ensure the timely diagnosis and optimal clinical outcome.
Streptoccoccus plurianimalium is a rare pathogen that has recently made a crossover from its common host, animals to humans. As reports start to emerge from this pathogen, it has come to light that it can cause clinically significant infections in a broad spectrum of systems. However, the mode of transmission of this pathogen has not yet been fully established. We report here a case of Streptoccoccus plurianimalium peritonitis in a patient undergoing continuous ambulatory peritoneal dialysis in our centre. To the best of our knowledge, this is the first case report of a Streptoc- coccus plurianimalium peritonitis in an end-stage kidney disease patient.