Unexplained severe lactic acidosis in emergency medicine
Journal Title: Journal of Case Reports and Studies - Year 2013, Vol 1, Issue 2
Abstract
A 49-year-old previously healthy man was admitted to the ICU after cardiac arrest following a short history with headache, blurred speech and reduced consciousness. After cardiopulmonary resuscitation perfusion rhythm was regained, but the patient didn`t regain consciousness. The arterial blood gas analysis at the ICU revealed a severe metabolic acidosis with pH at 6.86 and lactate levels of 16 mmol/L. The white blood cells count was also markedly increased (312 * 109 /L), and blood smear showed immature cells indicating acute leukemia. The severe metabolic acidosis, at first thought to be due to systemic hypoperfusion, did not improve in spite of fluid and vasopressor resuscitation. A CT scan of the head performed the next day, revealed massive cerebellar haemorrhage, edema in both hemispheres and signs of anoxic brain damage. Immunophenotyping of peripheral blood was consistent with Acute Myeloid Leukemia (AML).
Authors and Affiliations
Ole Erik Ulvin
Keywords
Related Articles
- EP ID EP393070
- DOI 10.15744/2348-9820.1.202
- Views 133
- Downloads 0
Juvenile Ossifying Fibroma - WHO Type
Juvenile ossifying fibroma is an uncommon clinical entity, its aggressive local behaviour and high recurrence rate mean that it is important to make an early diagnosis, apply the appropriate treatment and, especially, fo...
Fixed Pigment Erythema: A Challenge
We present a case of a woman with a history of Arthritis currently without directed therapy with controlled disease that occasionally presents joint pains. The patient presented a picture of but at least 2 years of appea...
Cost Effective Treatment of Pseudo Class III Malocclusion in a Permanent Dentition with a Simple Removable Appliance
Treating a Class III malocclusion has always been a challenge to the clinician beginning with the proper diagnosis, treatment options and the time of treatment. Few are of the opinion that the malocclusion should be corr...
Benign Pulmonary Metastasizing Leiomyoma
Benign metastasizing leiomyoma (BML) is a rare event that occurs in middle aged women with a history of uterine myomas. It is characterized by multiple leiomyomatous lesions in many tissues and organs, especially in the...
Jejunal Adenocarcinoma: An Unusual Cause of Small Bowel Obstruction
We report the case of a 52 year old man having no previous abdominal surgery who presented with small bowel obstruction. Computerised tomography showed mid jejunal obstruction, however, the cause of the obstruction could...