The Quarterly journal of medicine
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Two patients, both with short bowel syndrome, presented with severe D-lactic acidosis associated with subacute small bowel obstruction and bizarre neurological signs. In neither patient were D-lactic acid-producing organisms isolated from the upper intestine. In both, upper intestinal aspirates yielded a glucose-fermenting yeast, Torulopsis glabrata. ⋯ One patient has evidence of mild persisting renal tubular damage. The same patient responded to oral antibiotics but the other relapsed frequently despite continuous antibiotic treatment. He was shown to be thiamine deficient and since the administration of oral thiamine he has had no recurrence of symptoms or of D-lactic acidosis.