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A fatal case of Norwegian scabies in a patient with diabetes mellitus

  • Nur Atina Rahmawati ,
  • Alvi Chomariyati ,
  • Sony Wibosono Mudjanarko ,

Abstract

Background: Diabetes mellitus (DM) is characterized by hyperglycemia due to a defect in insulin secretion, action, or both. Immunocompromised individuals such as those with DM tend to suffer from skin disorders, including crusted scabies (Norwegian scabies). However, studies regarding the incidence of Norwegian scabies are still limited. This article reports a case of an elderly diabetic patient suffering from crusted scabies.

Case Presentation: A 67-year-old male patient was referred to Dr. Soetomo Hospital with sepsis caused by suspected skin infection, hypertension, and type 2 DM. The patient presented with a chief complaint of recurrent skin diseases throughout the body and itching for the past three years. The itching became severe in the last three weeks prior to the hospital admission. The patient had a medical history of diabetes, tuberculosis, hypertension, and arrhythmia. Based on our assessments the patient was diagnosed with crusted scabies, septic shock, sepsis, pneumonia, pulmonary tuberculosis, hypoalbuminemia, type 2 DM, and erythroderma. The patient received oxygen, antibiotics, norepinephrine, albumin, ranitidine, metoclopramide, NovoRapid, ventolin nebules, rehydration, topical keratolytic cream, and scabicidal cream as therapies. However, on the 3rd day of the treatment, the patient suffered from type 1 respiratory failure and passed away the next day due to septic shock.

Conclusion: We reported a diabetic male patient suffering from crusted scabies, accompanied by pneumonia, pulmonary tuberculosis, hypoalbuminemia, and type 1 respiratory failure. Secondary infections had been developed at the time of presentation. Therefore, establishing an early diagnosis of Norwegian scabies will help prevent the disease's progression.

References

  1. Chan WB, Chen JF, Goh S-Y, Vu TTH, Isip-Tan IT, Mudjanarko SW, et al. Challenges and unmet needs in basal insulin therapy: lessons from the Asian experience. Diabetes Metab Syndr Obes. 2017;10:521–32. Available from: https://pubmed.ncbi.nlm.nih.gov/29276400
  2. International Diabetes Federation (IDF) [Internet]. International Year Book and Statesmen’s Who’s Who. Brill; Available from: http://dx.doi.org/10.1163/1570-6664_iyb_sim_org_38965
  3. Agency of Health Research and Development of the Indonesian Ministry of Health. Indonesian Sample Registration System 2014
  4. Zahra Z, Ramadhani CT, Mamfaluti T, Pamungkas SR, Firdausa S. Association between depression and HbA1c levels in the elderly population with type 2 diabetes mellitus during COVID-19 pandemic. Narra J. 2022;2(1). Available from: http://dx.doi.org/10.52225/narra.v2i1.51
  5. Karthikeyan K. Crusted scabies. Indian J Dermatol Venereol Leprol. 2009;75(4):340. Available from: http://dx.doi.org/10.4103/0378-6323.53128
  6. Agusni I. NORWEGIAN SCABIES IN AIDS PATIENT: A CASE REPORT. Indones J Trop Infect Dis. 2016;6(2):49. Available from: http://dx.doi.org/10.20473/ijtid.v6i2.3163
  7. Scheinfeld N. Controlling scabies in institutional settings: a review of medications, treatment models, and implementation. Am J Clin Dermatol. 2004;5(1):31-7. doi: 10.2165/00128071-200405010-00005.
  8. Niode NJ, Adji A, Gazpers S, Kandou RT, Pandaleke H, Trisnowati DM, et al. Crusted Scabies, a Neglected Tropical Disease: Case Series and Literature Review. Infect Dis Rep. 2022;14(3):479–91. Available from: https://pubmed.ncbi.nlm.nih.gov/35735761
  9. Lynar S, Currie BJ, Baird R. Scabies and mortality. Lancet Infect Dis. 2017;17(12):1234. Available from: http://dx.doi.org/10.1016/s1473-3099(17)30636-9
  10. Tjokroprawiro A. New approach in the treatment of T2DM and metabolic syndrome (focus on a novel insulin sensitizer). Acta Med Indones. 2006;38(3):160-6. PubMed PMID: 17119268. Epub 2006/11/23.
  11. Revita E, Dayani DP, Isfandiari MA. Relationship between Perception of Individual Susceptibility and Barriers to Treatment Action in Scabies Patients. J Berk Epidemiol. 2021;9(3):310. Available from: http://dx.doi.org/10.20473/jbe.v9i32021.310-317
  12. Albayrak H, Güleç AI, Uslu E, Bafikan E, Ince N. Norwegian scabies in elderly diabetic patient : A case report. Turkish Journal of Geriatrics. 2014;17(3):321-3
  13. Furuya K, Nakajima H, Sasaki Y, Ishiko A, Urita Y. A scabies outbreak in a diabetic and collagen disease ward: Management and prevention. Exp Ther Med. 2016/10/27. 2016;12(6):3711–5. Available from: https://pubmed.ncbi.nlm.nih.gov/28105102
  14. Wong SSY, Woo PCY, Yuen K-Y. Unusual laboratory findings in a case of Norwegian scabies provided a clue to diagnosis. J Clin Microbiol. 2005;43(5):2542–4. Available from: https://pubmed.ncbi.nlm.nih.gov/15872307
  15. Leung V, Miller M. Detection of scabies: A systematic review of diagnostic methods. Can J Infect Dis Med Microbiol = J Can des Mal Infect la Microbiol medicale. 2011;22(4):143–6. Available from: https://pubmed.ncbi.nlm.nih.gov/23205026
  16. Davis JS, McGloughlin S, Tong SYC, Walton SF, Currie BJ. A novel clinical grading scale to guide the management of crusted scabies. PLoS Negl Trop Dis. 2013;7(9):e2387–e2387. Available from: https://pubmed.ncbi.nlm.nih.gov/24069468

How to Cite

Rahmawati, N. A., Chomariyati, A. ., & Mudjanarko, S. W. . (2022). A fatal case of Norwegian scabies in a patient with diabetes mellitus. Bali Medical Journal, 11(2), 870–874. https://doi.org/10.15562/bmj.v11i2.3500

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Nur Atina Rahmawati
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Alvi Chomariyati
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Sony Wibosono Mudjanarko
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