Objectives Report a novel case of new-onset type 1 diabetes in a pediatric patient presenting with DKA and concurrent Streptococcus intermedius brain abscess. Case presentation The following case report is that of a previously healthy 12 year-old girl presenting with new-onset type 1 diabetes with mild diabetic ketoacidosis and subsequently found to have a brain abscess. Over the course of her hospital stay, she developed seizures and was found to have a 1.3 × 1.0 × 1.2 cm right frontal parasagittal mass culture-positive for S. intermedius. Neurologic symptoms were unmasked once insulin treatment was initiated and ketosis improved, supporting the relationship between therapeutic ketosis and the management of medication-refractory epilepsy. Conclusions This case both supports the relationship between therapeutic ketosis and the management of medication-refractory epilepsy and highlights the need to carefully consider comorbid conditions in patients with DKA and new onset neurological symptoms.

中文翻译：

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以中间链球菌脑脓肿为表现的小儿糖尿病酮症酸中毒

目的 报告一例新发 1 型糖尿病的新病例，患儿表现为 DKA 和并发中间链球菌脑脓肿。病例报告 以下病例报告是一名既往健康的 12 岁女孩，因新发 1 型糖尿病合并轻度糖尿病酮症酸中毒，随后发现脑脓肿。在住院期间，她出现癫痫发作，并被发现有 1.3 × 1.0 × 1.2 cm 的右额旁矢状窦肿块培养阳性中间链球菌。一旦开始胰岛素治疗并且酮症得到改善，神经系统症状就会显现出来，这支持了治疗性酮症与药物难治性癫痫管理之间的关系。