Presentation A 60 year old male was admitted with complaints of dysuria and non-specific abdominal pain for 1 week, accompanied by malaise followed by low-grade fevers and chills. H/O patient and Medications Type 2 diabetes mellitus (recent HbA1c 7.5%) Glyburide 10 mg BID, Metformin 850 mg BID, Lisinopril 10 mg daily, Aspirin 50 mg daily. Physical examination Marked tachycardia and orthostatic hypotension, but examination was otherwise nonspecific.
No cardiac murmur was present, and the prostate was non-tender. Initial diagnosis Diabetic ketoacidosis and complicated urinary tract infection. Laboratory tests Complete blood count with differential: WBC of 19,440 (73% segmented neutrophils, 17% band forms), sodium 126, creatinine of 1.7 Basic metabolic panel: Glucose of 441 Urinalysis and urine culture: Urinalysis demonstrated no leukocyte esterase or nitrite, no microbial growth Blood…
