• Yu Xia, Xiaofeng Zhu, and Changxue Wu.
• Department of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
• Medicine (Baltimore). 2023 Jan 13; 102 (2): e32659e32659.

RationaleLactic acidosis is a disease in which lactic acid accumulates in the blood and causes acidosis in the patient. The criteria for diagnosis are a lactate level of >2 mmol/L in the blood and a blood pH of <7.2.Patient ConcernsA 72-year-old Asian female with a history of diabetes for 20+ years was admitted to the hospital with the chief complaint of "dry mouth, polydipsia for 20+ years, loss of appetite for 5+ days, vomiting for 1-day." She was admitted with a blood gas pH of 6.795, and a lactate level of >30 mmol/L.DiagnosesType 2 diabetes mellitus with lactic acidosis, ketoacidosis, chronic renal insufficiency, hypertensive disease, and coronary arteriosclerotic heart disease.InterventionsShe was treated with symptomatic rehydration and ketone reduction immediately, but then became unconscious and was admitted to the intensive care unit, where she was administered symptomatic support and continuous renal replacement therapy. As the blood culture showed Aeromonas veronii, she was administered a sensitive antibiotic in conjunction.OutcomesHowever, after achieving a stable internal environment and good infection control, the patient's family decided to discontinue treatment because of persistent heart failure with acute exacerbation of chronic renal insufficiency complicated by gastrointestinal bleeding.LessonsLactic acidosis has low incidence, poor prognosis, and high morbidity and mortality rates. Special attention should be paid to infection-induced acidosis, especially in patients with combined multi-organ insufficiency. Early diagnosis and active management can improve the patient prognosis.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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