[A fatal course of alcohol-induced ketoacidosis]

Several days after not eating anything while drinking heavily a 45-year-old alcoholic developed severe ketoacidosis. He was admitted to hospital in a stable cardiovascular condition, but already in a comatose state with Kussmaul breathing. There was a marked metabolic acidosis (pH 6.8; base deficit -30 mmol/l), the urine was positive for ketone bodies, and serum lactate was 24 mmol/l. There was a marked hypoglycaemia (40 mg/dl). Despite intensive treatment it was not possible to prevent multiple organ failure, of which the patient soon died.