Hypoglycemia as a manifestation of sepsis

The American Journal of Medicine
S I MillerR E Baughn

Abstract

Hypoglycemia has rarely been described as a clinical sign of severe bacterial sepsis. We recently encountered nine patients in whom hypoglycemia (mean serum glucose of 22 mg/dl) was associated with overwhelming sepsis. Clinical disease in these patients included pneumonia and cellulitis; in three patients, no focus of infection was apparent. Altered mental status, metabolic acidosis, leukopenia, abnormal clotting studies and bacteremia were common features in these cases. In four patients, no cause for hypoglycemia other than sepsis was present. In five patients, another possible metabolic cause for hypoglycemia was present (alcoholism in four and chronic renal insufficiency in one) although none had been observed to be hypoglycemic on previous hospitalizations. Streptococcus pneumoniae (three cases) and Hemophilus influenzae, type b, (two cases) were the most common pathogens, and the over-all mortality was 67 per cent. The mechanism(s) for hypoglycemia with sepsis is not well defined. Depleted glycogen stores, impaired gluconeogenesis and increased peripheral glucose utilization may all be contributing factors. Incubation of bacteria in fresh blood at room temperature does not increase the normal rate of breakdown of glucose ...Continue Reading

References

May 1, 1976·Annals of Internal Medicine·J D Coonrod, R P Leach
Jan 1, 1977·Nephron·S J Peitzman, B N Agarwal
Sep 1, 1978·Archives of Internal Medicine·E A RutskyS Pek
Jan 1, 1979·Archives of Internal Medicine·V K BansalJ E Hano
May 1, 1977·The American Journal of Medicine·C SingerD Armstrong
Aug 1, 1977·The American Journal of Clinical Nutrition·D W Wilmore
Nov 1, 1977·Archives of Internal Medicine·V Gopal, A L Bisno
Jul 1, 1968·Metabolism: Clinical and Experimental·K F LaNoueJ P Daniels
Jan 1, 1973·The Journal of Infectious Diseases·J C Guckian
Oct 1, 1974·The American Journal of Physiology·J P Filkins, R P Cornell
Oct 1, 1972·Proceedings of the Society for Experimental Biology and Medicine·J A SpitzerJ J Spitzer
Apr 1, 1973·The American Journal of Medicine·E J WinslowR M Gunnar
Mar 1, 1973·The Journal of Pediatrics·C Y YeungC M Yeung
Jul 1, 1973·Diabetes·M FrizzellJ B Field
Feb 1, 1969·Proceedings of the Society for Experimental Biology and Medicine·J W ShandsH Martin
Mar 1, 1970·Annals of Surgery·J L BerkM J Gerber
Apr 1, 1972·The American Journal of Medicine·E B MarlissG F Cahill
Jan 4, 1971·JAMA : the Journal of the American Medical Association·M G White, N A Kurtzman
Feb 13, 1970·Science·P FeligG F Cahill
Mar 1, 1970·Annals of Internal Medicine·A L Bisno, J C Freeman
May 25, 1970·JAMA : the Journal of the American Medical Association·M D GrantH R Brodman
Dec 24, 1970·The New England Journal of Medicine·P FeligG Klatskin
Nov 1, 1970·The Journal of Pediatrics·C Y Yeung
Aug 1, 1971·Archives of Internal Medicine·Ramon MedalleChristine Waterhouse
Dec 1, 1965·American Journal of Diseases of Children·P Nader, R Leonards
Dec 1, 1965·The American Journal of Medicine·U G Hodgin, J P Sanford
May 1, 1967·Annals of Internal Medicine·M C DeMouraF Madeira
Jul 1, 1960·The Journal of Experimental Medicine·J P SANFORDC GOTT
Apr 1, 1963·The Journal of Clinical Investigation·J B FIELDG E MORTIMORE
Mar 1, 1964·Proceedings of the Society for Experimental Biology and Medicine·W E FARRAR, J G WATSON
Mar 1, 1965·Transactions of the Royal Society of Tropical Medicine and Hygiene·A J MCFADZEAN, R T YEUNG
Oct 21, 1961·Lancet·P B NEAME, S M JOUBERT

❮ Previous
Next ❯

Citations

Jun 1, 1984·European Journal of Clinical Microbiology·B TrollforsT Sandberg
Dec 15, 2006·Aging Clinical and Experimental Research·Edoardo MannucciNiccolò Marchionni
Jan 1, 1985·Transactions of the Royal Society of Tropical Medicine and Hygiene·B TekluR C Turner
May 18, 2001·Transactions of the Royal Society of Tropical Medicine and Hygiene·D ModianoA Sawadogo
Jul 14, 1983·The New England Journal of Medicine·N J WhiteR C Turner
Apr 27, 1995·The New England Journal of Medicine·F J Service
Sep 1, 2006·Critical Care Medicine·Titia M VriesendorpJoost B L Hoekstra
Jun 1, 1984·Postgraduate Medical Journal·T D Walsh
Oct 13, 2006·Malaria Journal·Ian A ClarkWilliam B Cowden
Oct 16, 2004·Journal of the American Veterinary Medical Association·Merilee F CostelloLesley G King
Apr 20, 2014·PLoS Pathogens·Amelia K PintoMichael S Diamond
Mar 12, 2010·The American Journal of the Medical Sciences·Eric M MortensenAntonio Anzueto
Oct 31, 2006·The American Journal of Medicine·Shamsuddin AlamgirMichael W Peterson
Jun 6, 2009·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Carl F RaetzschTerry P Combs
Oct 3, 2009·The Journal of Small Animal Practice·K J ParsonsS P Gregory
Apr 1, 1990·Journal of the American Geriatrics Society·A Scheetz
Sep 1, 1985·Journal of the American Geriatrics Society·P BerkmanI Yust
Aug 26, 1998·Journal of the American Geriatrics Society·S ShiloM Sonnenblick
Dec 17, 2008·International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases·I-Shiow JanLi-Na Lee
Jan 1, 1995·The American Journal of Medicine·B A Mizock
Nov 1, 1989·Transactions of the Royal Society of Tropical Medicine and Hygiene·T ButlerM Islam
Feb 1, 1988·Diabetes/metabolism Reviews·R T FrizzellA D Cherrington
Mar 1, 1988·Diabetes/metabolism Reviews·J E Gerich, P J Campbell
Apr 26, 2000·Revista do Hospital das Clínicas·J FaintuchJ J Gama-Rodrigues
Jan 1, 1984·The American Journal of Emergency Medicine·J P Filkins
May 1, 1993·The American Journal of Emergency Medicine·D M RubinoJ B Leikin
Aug 15, 2017·Journal of Diabetes Investigation·Hiroshi TanakaMasaya Hosokawa
Jan 26, 2016·The Korean Journal of Physiology & Pharmacology : Official Journal of the Korean Physiological Society and the Korean Society of Pharmacology·Sung-Su KimHong-Won Suh
Jul 11, 2008·Current Opinion in Critical Care·Titia M VriesendorpJoost B L Hoekstra
Jul 7, 2018·EMBO Molecular Medicine·Lise Van WyngeneClaude Libert
Oct 22, 2016·American Journal of Physiology. Lung Cellular and Molecular Physiology·Yujie JiangLiao Pinhu
Aug 23, 2019·Annals of the American Thoracic Society·Andreas Vestergaard JensenUNKNOWN Members of the CAPNETZ study group except the authors:
Nov 5, 2002·Clinical and Diagnostic Laboratory Immunology·Senri OguriYasuo Endo
May 1, 1985·Annals of Neurology·R Malouf, J C Brust
Sep 9, 2020·Journal of Veterinary Emergency and Critical Care·Simon P HagleySteven E Epstein
Oct 1, 1990·Journal of Endocrinological Investigation·J A RomijnH P Sauerwein
Nov 1, 1987·Postgraduate Medicine·K F McFarlandS D Ferguson
Apr 18, 2017·Biomedical Reports·Yu-Jang SuChia-Jung Liao
Dec 20, 2018·International Journal of Molecular Sciences·Jinhui LiYusen Liu

❮ Previous
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