An 8-year-old boy presented to our otolaryngology clinic three times in a 3-month period for treatment of acute auricular perichondritis. At each visit he was treated with an antibiotic, and he responded quickly in each case, with a complete resolution of his infection. The results of standard autoimmune laboratory tests were negative. Three months after his initial presentation, the patient developed the classic signs and symptoms of diabetes mellitus, including polydipsia, polyuria, and weight loss. He was diagnosed with and treated for type 1 (insulin-dependent) diabetes, and his recurrent infections ceased. There has been no recurrence over a 4-year follow-up period. This case report serves to illustrate the fact that recurrent infections may be the first sign of diabetes. Since diabetes and perichondritis are known to be associated, we recommend that for patients who present with recurrent episodes of perichondritis, a basic metabolic panel and measurement of the glycosylated hemoglobin level be added to standard autoimmune laboratory testing to possibly identify undiagnosed diabetes.
Recurrent infections may be the first sign of diabetes mellitus in previously undiagnosed patients. We describe a case of recurrent auricular perichondritis in a child that represented the initial manifestation of diabetes. We also briefly review the literature on the association between these two diseases.
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