Endocrine Abstracts

Introduction: Deep abscess represent infectious emergencies. The aim of our study was to evaluate the clinical, biological, radiological and evolutionary of deep abscess in diabetic patients.

Patients and methods: A prospective descriptive study was conducted over a period of 12 months in 2017, including 52 diabetic patients hospitalized in the University Hospital with a our patients deep abscess.

Results: The average age of 52.4 years, a sex ratio of 2.06 M/F, type 2 diabetes predominant (84.6%), an average age of 7 years, a lack monitoring (53.8%), an average HbA1c of 10.5% and degenerative complications (69.2%). Clinical signs found in our patients were fever (34%), pain in the right upper quadrant (28%), earache (8%), localized pain (10%) and proptosis (14%). We noted that 40% were asymptomatic. Biological assessment achieved found a high CRP (88%) with an average of 47.4 mg/l, leukocytosis (50%), multiple abscesses on ultrasound (85%) with an average size of 7 cm, and infiltration/or collection at tomography (60%).We noted the following locations: liver (19), ocular (12), ORL (5), lung (4), psoas (2), breast (2), one conus medullaris, a tuboovarian, renal (2), mediastinal (2), parietal (1) and brain (1). A bacteriological analysis was performed in 90% of patients, blood culture (35%) and removal of pus (70%). Gram negative bacilli were predominant: E. coli (30%), Klebsiella (60%) for hepatic abscesses, pseudomonas aeruginosa (16.6%) of corneal abscess and specificity of Aspergillus fumigatus in the case of a complicated pansunisitis of orbital cellulitis. Combination therapy with surgical drainage (59.6%), an injectable antibiotic therapy alone (30.8%), bi or triple therapy (69.2%) with an average duration of 14 days and intensified insulin therapy. The outcome was favorable in 95% of patients. One patient who died in post-operative following a pulmonary embolism.

Conclusion: Our study highlighted the interest to seek a deep abscess before any imbalance with a clinical picture which is sometimes little noisy, to improve patients prognosis, which is overshadowed by the lesions severity and delayed diagnosis.