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Indian Journal of Emergency Medicine

Volume  10, Issue 2, April - June 2024, Pages 85-89
 

Case Report

Lactic Acidosis: A Diagnostic Conundrum

Anjali P. U1 , Jerry Jacob2 , Aruna C. Ramesh3

: 1 Junior Resident, 2 Assistant Professor,  3 Professor and H.O.D, Department of Emergency Medicine,  M S Ramaiah Medical College, Bangalore 560054, Karnataka,  India.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.10224.9

Abstract

Lactic acidosis is due to increased serum lactate (>5.0mmol/L) leading to decrease in  blood pH. Alcoholic keto-acidosis is one of the several etiologies where serum lactate level  rarely exceeds 3mmol/L. Here we present a case of 59yr old male presented to ED with c/o  abdominal pain and multiple episodes of vomiting following consumption of alcohol. On  examination, patient was tachypneic, tachycardic with BP of 90/60mmHg. Arterial blood gas  showed severe metabolic acidosis with a pH of 6.96, pCO2 of 21.4, pO2 of 57.1, HCO3 of 4.7 and  Lactate of 14.48. On probing history, attenders revealed consumption of illicit liquor by patient  on previous night giving rise to suspicion of methanol toxicity


Keywords : Lactic acidosis; Methanol intoxication.
Corresponding Author : Anjali P. U,