Lactic Acidosis in a Critically Ill Patient: Not Always Sepsis. Pediatr Emerg Care 2018 Sep;34(9):e165-e167
Date
09/05/2018Pubmed ID
30180106DOI
10.1097/PEC.0000000000001603Scopus ID
2-s2.0-85053360986 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
Lactic acidosis in the emergency department and other hospital settings is typically due to tissue hypoxia with sepsis being the most common cause. However, in patients with persistently elevated lactate without evidence of inadequate oxygen delivery, type B lactic acidosis should be considered. We report the case of a 12-year-old boy with relapsed and refractory pre-B-cell acute lymphoblastic leukemia who presented in distress with tachycardia, history of fever, and diffuse abdominal tenderness. The patient had severe metabolic acidosis with elevated lactate upon arrival to the emergency department. Despite aggressive fluid resuscitation and intravenous antibiotics, the patient's acidosis worsened. Serial blood cultures were negative, and he was eventually diagnosed with type B lactic acidosis secondary to relapsed acute lymphoblastic leukemia.
Author List
Schuh AM, Leger KJ, Summers C, Uspal NGAuthor
Abigail M. Schuh MD Associate Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acidosis, LacticAntineoplastic Agents
Child
Critical Illness
Diagnosis, Differential
Fatal Outcome
Humans
Lactic Acid
Male
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Sepsis
Tomography, X-Ray Computed
