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[Uncommon Yet Severe: Metabolic Acidosis from Concurrent Use of Paracetamol and Flucloxacillin]
Nikolay Todorov1,2, Patrick Bader1
1Klinik und Poliklinik für Innere Medizin. UniversitätsSpital Zürich, Zürich.
Introduction:
A 60-year-old polymorbid patient developed severe metabolic acidosis during weeks of treatment with flucloxacillin and paracetamol. The acidosis was triggered by an accumulation of 5-oxoproline due to pre-existing risk factors for glutathione deficiency as well as a ketoacidosis due to starvation. After treatment with N-acetylcysteine and hemofiltration, the acidosis completely resolved.
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