Ketoacidosis may complicate sepsis and the combination can be fatal.

Clinical features:

(1) presence of sepsis, especially septic shock

(2) elevation of blood ketone bodies

(3) metabolic acidosis

(4) exclusion of other causes of ketoacidosis (which may be difficult, especially with diabetes)


Basal vacuolization of renal tubular epithelial cells may be present as is seen with other causes of ketoacidosis.


The arterial ketone ratio (acetoacetate to hydroxybutyrate) is often decreased.

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