Periapical abscess precipitating diabetic ketoacidosis and reversible sepsis-induced cardiomyopathy: a case report - Report - DentalSpire

Diabetic Ketoacidosis and Reversible Sepsis-Induced Cardiomyopathy Triggered by a Periapical Abscess: A Case Study

  • By

  • Jixia Jin

  • Lian Liao

  • Yinhang Ren

  • Guiyun Li

  • Yuyang Qiu

  • July 15, 2026

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Clinical Report: Diabetic Ketoacidosis and Reversible Sepsis-Induced Cardiomyopathy

Overview

This case study presents a 57-year-old female with poorly controlled type 2 diabetes who developed diabetic ketoacidosis (DKA) and sepsis-induced cardiomyopathy (SICM) due to a periapical abscess. Following management, including antibiotics and fluid resuscitation, the patient showed improvement in cardiac function.

Background

Diabetic ketoacidosis (DKA) is a critical complication of diabetes, often triggered by infections, with odontogenic infections being a significant source. The relationship between diabetes and sepsis can lead to severe outcomes, including multi-organ dysfunction and cardiomyopathy.

Data Highlights

Case presentation: A 57-year-old female with DKA (pH 7.04, -hydroxybutyrate 7.19 mmol/L) and sepsis (procalcitonin 2.34 ng/mL) showed severe left ventricular dysfunction (ejection fraction 36%). Follow-up echocardiography on day 14 demonstrated recovery (ejection fraction 72%).

Key Findings

  • Odontogenic infections can precipitate DKA and sepsis in diabetic patients.
  • The patient exhibited severe DKA and SICM.
  • Implementation of sepsis management protocols, including antibiotics and fluid resuscitation, was crucial for recovery.
  • Recovery of cardiac function was observed after addressing the underlying infection and metabolic derangements.
  • Physical examination, including oral cavity inspection, is vital in evaluating patients with DKA or sepsis.

Clinical Implications

Healthcare professionals should be aware of odontogenic infections in diabetic patients presenting with DKA.

Conclusion

This case illustrates the link between odontogenic infections and metabolic complications in diabetes.

Related Resources & Content

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  4. conexiant, Conexiant, 2024 -- When Dental Decay Triggers Deadly Infection
  5. American Diabetes Association, Diabetes Care, 2024 -- Hyperglycemic Crises in Adults With Diabetes: A Consensus Report
  6. Surviving Sepsis Campaign, Intensive Care Medicine, 2026 -- international guidelines for management of sepsis and septic shock 2026
  7. European Heart Journal, Oxford Academic, 2024 -- Sepsis-induced cardiomyopathy
  8. Hyperglycemic Crises in Adults With Diabetes: A Consensus Report | Diabetes Care | American Diabetes Association
  9. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026 | Intensive Care Medicine | Springer Nature Link
  10. Sepsis-induced cardiomyopathy | European Heart Journal | Oxford Academic

Original Source(s)

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