Linezolid-induced fatal lactic acidosiss: an adverse reaction easily confu-sed with septic shock

Abstract:

Clinical data of 3 patients with linezolid-induced lactic acidosis treated in 2 hospitals in Beijing and Shandong were retrospectively analyzed, and relevant literatures at home and abroad were retrieved. The pathogenesis, risk factors, clinical manifestations, and treatment scheme were valuated. Three patients received linezolid anti-infection treatment due to their disease condition. At different phases of treatment, they developed lactic acidosis that was difficult to be explained with septic shock. After discontinuing linezolid and receiving bedside continuous veno-venous hemofiltration (CVVH) treatment, patient's blood lactate levels decreased significantly. It is clinically diagnosed linezolid-induced lactic acidosis finally, but the initial diagnosis was septic shock by all doctors. After active treatment, 2 patients recovered and 1 patient died. Linezolid-induced lactic acidosis is easily to be misdiagnosed as septic shock. Clinicians should enhance their understanding and recognition of the early diagnosis of the adverse reactions, take effective measures, so as to improve patient prognosis.