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A 68-year-old woman with diabetes mellitus that was treated with insulin was hospitalized because of abdominal pain and vomiting. She had been treated empirically for a urinary tract infection with trimethoprim–sulfamethoxazole for five days before admission. Her temperature was 38.4°C. Her abdomen was soft, with marked tenderness in the suprapubic area. Her leukocyte count was 45,000 per cubic millimeter, with 92 percent segmented neutrophils and 5 percent band forms. The glucose level was 569 mg per deciliter (31.6 mmol per liter), the blood urea nitrogen level was 57 mg per deciliter (20.3 mmol per liter), and the creatinine level was . . . [Full Text of this Article] |
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