Diabetic Ketoacidosis Triggered by Retropharyngeal Abscess Complicated by Descending Necrotizing Mediastinitis

Abstract

A 62-year-old woman with poorly controlled type 2 diabetes mellitus presented with a fever and altered consciousness. The patient was diagnosed with diabetic ketoacidosis (DKA) with a positive blood culture for group A Streptococcus. Although the source of infection was initially unclear, contrast-enhanced computed tomography revealed a retropharyngeal abscess (RPA) and descending necrotizing mediastinitis (DNM) that required surgical drainage. RPA with DNM is rare and potentially fatal in adults and is often missed without high clinical suspicion. In severe DKA, altered mental status and hemodynamic instability may obscure the underlying infection, emphasizing the importance of a thorough evaluation.

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BibTeX RIS

BibTeX

@article{uchida2026diabetic,
  title = {{Diabetic Ketoacidosis Triggered by Retropharyngeal Abscess Complicated by Descending Necrotizing Mediastinitis}},
  author = {Daisuke Uchida and Tohru Sekiguchi and Kohei Yamahara and Hideyuki Takeuchi and Atsuko Takai and Takashi Mikamo and Naoyuki Iso-O and Kentaro Kikuchi and Masumi Hara},
  journal = {Internal Medicine},
  year = {2026},
  month = aug,
  doi = {10.2169/internalmedicine.6175-25},
  url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/15/65_6175-25/_article},
  note = {CC BY-NC-ND},
}

RIS

TY  - JOUR
TI  - Diabetic Ketoacidosis Triggered by Retropharyngeal Abscess Complicated by Descending Necrotizing Mediastinitis
AU  - Daisuke Uchida
AU  - Tohru Sekiguchi
AU  - Kohei Yamahara
AU  - Hideyuki Takeuchi
AU  - Atsuko Takai
AU  - Takashi Mikamo
AU  - Naoyuki Iso-O
AU  - Kentaro Kikuchi
AU  - Masumi Hara
PY  - 2026
DA  - 2026/08/01
JO  - Internal Medicine
DO  - 10.2169/internalmedicine.6175-25
UR  - https://www.jstage.jst.go.jp/article/internalmedicine/65/15/65_6175-25/_article
AB  - A 62-year-old woman with poorly controlled type 2 diabetes mellitus presented with a fever and altered consciousness. The patient was diagnosed with diabetic ketoacidosis (DKA) with a positive blood culture for group A Streptococcus. Although the source of infection was initially unclear, contrast-enhanced computed tomography revealed a retropharyngeal abscess (RPA) and descending necrotizing mediastinitis (DNM) that required surgical drainage. RPA with DNM is rare and potentially fatal in adults and is often missed without high clinical suspicion. In severe DKA, altered mental status and hemodynamic instability may obscure the underlying infection, emphasizing the importance of a thorough evaluation.
SN  - 1349-7235
SN  - 0918-2918
ER  -

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