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A Patient with Recurrent Myxedema Coma: What Was the Missing Link?

  • Marvin Wei Jie Chua
    Correspondence
    Requests for reprints should be addressed to Marvin Wei Jie Chua, Consultant Endocrinologist, Department of General Medicine, Sengkang General Hospital, 110 Sengkang East Way, Singapore, 544886.
    Affiliations
    Department of General Medicine, Sengkang General Hospital, Singapore
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Published:September 28, 2021DOI:https://doi.org/10.1016/j.amjmed.2021.08.034
      The patient is a 51-year-old male with type 2 diabetes mellitus complicated by stage 3 chronic kidney disease with nephrotic syndrome (latest 24-hour urine protein was 3.25 g/d). He was initially admitted for fever, and computed tomography (CT) of the abdomen and pelvis showed an ischiorectal abscess (Figure 1), which required CT-guided drainage and prolonged antibiotic therapy.
      Figure 1
      Figure 1Computed tomography of the abdomen and pelvis showing a large loculated abscess in the right ischiorectal fossa.
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