The American journal of emergency medicine
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Diabetic ketoacidosis (DKA) occurs frequently among children and adolescents with type 1 diabetes. Although a number of complications may occur during episodes of DKA, significant cardiac arrhythmias are uncommon. We present the case of an adolescent who presented with severe DKA and wide complex tachycardia that was unresponsive to multiple doses of adenosine and ultimately required synchronized cardioversion. This case reminds the clinician of the importance of cardiac monitoring in children with DKA, particularly in the setting of hyperkalemia.
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Chikungunya is an arboviral infection that manifests as an acute viral illness associated with an inflammatory arthritis. It was first described during an outbreak in Tanzania in 1952 and, until 2013, outbreaks had been limited in Africa, Asia, Europe and the Indian and Pacific Oceans. ⋯ As of October 2020, the CDC records 17 travel-associated cases of Chikungunya in six states including California, Illinois, Missouri, North Carolina, Tennessee and Texas. This is the first reported case of Chikungunya acquired in Florida with no international travel history.