Clinical Manifestations
The clinical manifestations of DKA include [25]:
- Dehydration
- Kussmaul respiration (deep, rapid, sighing)
- Nausea and vomiting
- Abdominal pain (can mimic an acute abdomen)
- Progressive clouding of consciousness and coma
- Increased leukocyte count with left shift (does not necessarily indicate sepsis)
- Non-specific elevation of serum amylase
- Ketotic breath
- Increased heart rate
Fever is not a feature of DKA. Think about sepsis in a child or young person with DKA who has any of the following:
- fever or hypothermia
- hypotension
- refractory acidosis
- lactic acidosis