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

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.