Case of the Month #60 The Acidotic Coma: A Case of Unexplained Rigidity

Published 29/01/2026

What treatment would you start acutely?

  1. Severe cases of Starvation Ketoacidosis, particularly in patient with Diabetes, can be treated with Fixed Rate Intravenous Insulin Infusion (FRIII), in combination with IV Dextrose. Mild cases can be management with IV fluid resuscitation. 
  2. Renal Replacement Therapy if the patient develops anuria or hyperkalaemia. 
  3. Monitoring and replacement of electrolytes (Phosphate, Magnesium) and Vitamins (particularly Thiamine) should be considered in cases of starvation ketoacidosis.