An 18-month-old girl was brought to the pediatric endocrinology department after being diagnosed with diabetes mellitus (DM) induced diabetic ketoacidosis (DKA). The patient had a persistent fever of 38°C, vomiting, abdominal pain, and right ear discoloration for three days, which was bluish to dark in color, followed by discharge two days later, and ear swelling (Figure 1). The child had arrived three weeks before the admission to the emergency department with her parents, with a history of a vesicle-like skin rash on her upper and lower limbs.
The parents revealed that the child has not been vaccinated and had a three-week history of diminished activity, generalized fatigue, and persistent weight loss. She was diagnosed with chickenpox and discharged on the same day after being given supportive care. Physical examination: The right auricle had a wet gangrenous black-to-brownish…
