Successfully managed alcoholic ketoacidosis with sepsis leading to multiple organ dysfunction syndrome: a case report

Abstract

We present the case of a 28-year-old male with a history of alcohol dependency and smoking, who presented with chest pain, shortness of breath, and altered sensorium. He exhibited severe metabolic acidosis, hypoglycemia, low platelet count, and acute kidney injury. Alcoholic ketoacidosis was suspected due to ketonuria, metabolic acidosis, and ketonemia, compounded by electrolyte abnormalities and radiographic findings of pneumonia. Prompt intervention included intravenous fluids, electrolyte correction, thiamine supplementation, broad-spectrum antibiotics, and diuretics. Thiamine played a pivotal role in the patient’s recovery, with significant improvement in consciousness observed within a day. After six days, the patient was discharged in stable condition, with normal renal and hepatic function at follow-up. This case emphasizes the need for early recognition and comprehensive management in alcoholic ketoacidosis, highlighting thiamine’s crucial role in treatment success.