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management, diabetic keto-acidosis, sepsis, thyrotoxicosis, thyroid-storm







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Thyroid storm (TS) is a relatively rare but life-threatening complication of an overactive thyroid that can manifest in a myriad of ways due to its multisystem involvement. Due to its relatively high mortality rate, it is essential that TS is recognized and treated promptly. TS can occur due to trauma, drugs, and sepsis. Identifying TS as a diagnosis is challenging to pinpoint due to its similar presentation to more common pathologies like sepsis and diabetic ketoacidosis (DKA). Here, we present a case of a 31-year-old African-American woman with type 2 diabetes mellitus following sepsis secondary to Escherichia coli pyelonephritis and DKA. Despite standard sepsis treatment, which included appropriate intravenous fluids and antibiotics, the patient did not improve. Further workup, utilizing the Burch-Wartofsky score, helped identify TS as the underlying cause of the patient’s hospitalization, despite no history of underlying thyroid disease. The inclusion of thyroid pathology as part of the differential diagnosis and workup of a patient with a sepsis-like presentation to avoid anchoring bias warrants further investigation.


Acknowledgements; This case report was pursued under the guidance and tutelage of JP, a physician at Magnolia Regional Health Center. AMJ, MK, VHC, and BM each substantially contributed to the genesis and design of this case report and assisted in the acquisition, analysis, and interpretation of articles utilized in this case report which required data collection from a variety of search engines such as OVID Medline and PubMed. In addition, VHC and BM obtained verbal informed consent from the patient who agreed to have this case report written. In addition to JP, all authors actively participated in the writing of multiple iterations until finally concocting a final draft to be reviewed and approved. VHC and BM are residents at Magnolia Regional Health Center and JP served as the senior author. Furthermore, all authors read and approved the final manuscript.

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Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.



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