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Silent diabetes mellitus, periodontitis, and a new case of thalamic abscess

Karageorgiou, I, Chandler, C and Whyte, MB (2014) Silent diabetes mellitus, periodontitis, and a new case of thalamic abscess [Report]

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Abstract

Brain abscess is an unusual complication of uncontrolled diabetes. A solitary thalamic abscess is an uncommon type of brain abscess. We report a case of thalamic abscess, whereupon diabetes mellitus and periodontitis were diagnosed. The diagnosis and management of thalamic abscess, and the interplay of type 2 diabetes and periodontitis are discussed. A 56-year-old, Caucasian, man with no medical or travel history, presented with 5-day symptoms of meningeal irritation. Body mass index 30.6 kg/m2. CT demonstrated a solitary midline lesion with neoplasia as a differential diagnosis. It was biopsied and cultures grew Streptococcus milleri. He was treated by stereotactic puncture, external drainage and targeted intrathecal and systemic antibiotic therapy. HIV negative but glycated haemoglobin (HbA1c) 10.7% (93 mmol/mol). Dental examination revealed a small molar abscess. Radiological resolution of the thalamic abscess occurred within 2 months. Diabetes improved with 7 weeks of insulin, and maintained on metformin, HbA1c 6.9% (51 mmol/mol). There was no residual neurological disability.

Item Type: Report
Subjects : Nutrition
Divisions : Faculty of Health and Medical Sciences > School of Biosciences and Medicine > Department of Nutritional Sciences
Authors :
NameEmailORCID
Karageorgiou, IUNSPECIFIEDUNSPECIFIED
Chandler, CUNSPECIFIEDUNSPECIFIED
Whyte, MBUNSPECIFIEDUNSPECIFIED
Date : 21 July 2014
Identification Number : 10.1136/bcr-2014-204654
Copyright Disclaimer : Copyright © 2016 by the BMJ Publishing Group Ltd. All rights reserved.
Depositing User : Symplectic Elements
Date Deposited : 19 Oct 2016 07:43
Last Modified : 31 Oct 2017 18:48
URI: http://epubs.surrey.ac.uk/id/eprint/812493

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