Abstract
RATIONALE: Fulminant type 1 diabetes mellitus (FT1DM) is a hyperacute form of diabetes characterized by rapid β-cell destruction. It is often underdiagnosed due to its varied presentations. Typhoid fever, a life-threatening systemic infection caused by Salmonella enterica serovar Typhi (S. Typhi), has been infrequently documented in association with FT1DM. This case stress the importance of early diagnosis and aggressive management of FT1DM, particularly when triggered by infectious diseases like typhoid fever. PATIENT CONCERNS: A 33-year-old male presented with high fever, persistent pruritic rash, generalized lymphadenopathy, severe diarrhea, gastrointestinal bleeding, and acute hyperglycemic crisis with ketoacidosis. DIAGNOSES: Extensive diagnostic workup, including laboratory tests, microbiological cultures, and serological profiling, confirmed the diagnosis of FT1DM complicated by typhoid fever. INTERVENTIONS: The patient was treated with an intensive regimen designed to stabilize his metabolic status and manage the infection. OUTCOMES: The comprehensive therapeutic intervention was successful, with the patient's symptoms being alleviated and his condition stabilized. LESSONS: This case underscores the importance of considering FT1DM in acute metabolic emergencies with infectious comorbidity, the necessity for thorough microbiological evaluation in febrile diabetic crises, and the potential pathogenic interplay between typhoid fever and FT1DM onset.