Emergency Cases Northwest Group
023 Not an Infection
Situation
A DKA patient had a high WCC. This did not represent an infection.
Background
A 65 year old man presented with DKA. His WCC was 20. It was repeated;
it rose to 28. No antibiotics were administered. Once his DKA was
treated the WCC reduced to 7.
Assessment
The raised WCC was reactive and a result of his DKA. There were no
infective signs or symptoms. There was no infection and antibiotics were
not indicated.
Recommendation
Know that DKA can cause a very high WCC, often >20.
An infection such as pneumonia can precipitate DKA.
However in the absence of any convincing history or clinical findings [ie fever, cough, dysuria etc] of an infection, antibiotics are not indicated.
But if you are in doubt then discuss with an experienced
colleague.
PLEASE DO NOT INCLUDE ANY PATIENT IDENTIFIABLE DATA OR
GEO-LOCATION DATA IN THE SUBMISSION OR IN ANY ATTACHED
IMAGES
Emergency Cases Northwest Group