SEVERE LACTIC ACIDOSIS: COULD IT BE THE HEART?

Trimethoprim/Sulfamethoxazole-Induced Severe Lactic Acidosis

Propylene glycol (PG) is used as a solvent in numerous medications, including trimethoprim/sulfamethoxazole (TMP/SMX) and lorazepam, and is metabolized in the liver to lactic acid. Cases of lactic acidosis related to PG toxicity have been described and always involved large doses of benzodiazepines and PG. We present the first case of severe lactic acidosis after a 3-day course of TMP/SMX alone...

Can albuterol be blamed for lactic acidosis?

Albuterol is an uncommonly recognized culprit in causing lactic acidosis. While treating asthmatics, lactic acidosis creates a paradoxical situation in which, despite improvement in bronchospasm, patients look more dyspneic as a compensatory mechanism for metabolic acidosis. This might lead to misinterpretation of the situation with increased albuterol dosing, creating a sort of vicious cycle u...

Obscure Severe Infrarenal Aortoiliac Stenosis With Severe Transient Lactic Acidosis

A 57-year-old man presented with sudden onset of leg pain, right-sided weakness, aphasia, confusion, drooling, and severe lactic acidosis (15 mmol/L). He had normal peripheral pulses and demonstrated no pain, pallor, poikilothermia, paresthesia, or paralysis. Empiric antibiotics, aspirin, full-dose enoxaparin, and intravenous fluid were initiated. Lactic acid level decreased to 2.5 mmol/L. The ...

Could it be Lyme neuroborreliosis?

Lactic Acidosis

Lactic acidosis is a form of metabolic acidosis due to the inadequate clearance of lactic acid from the blood. Lactate is a byproduct of anaerobic respiration and is normally cleared from the blood by the liver, kidney and skeletal muscle. Lactic acidosis occurs when the body's buffering systems are overloaded and tends to cause a pH of ≤7.25 with plasma lactate ≥5 mmol/L. It is usually caused ...