[D-lactic acidosis and encephalopathy in short-bowel syndrome occurring during antibiotic treatment].
A 24 year-old patient with a short-bowel syndrome receiving home parenteral nutrition in addition to oral feeding for 32 months was treated by oral trimethoprim-sulfamethoxazole for urinary tract infection. Three days later, he developed neurologic disorders associated with severe hyperchloremic acidosis and high plasma level of D-lactate. This is a rare complication of intestinal malabsorption due to small bowel by-pass or extensive resection due to transient alteration of intestinal microflora induced by the oral antibiotic treatment. Diagnosis requires a high indice of suspicion.
Service de Gastroentérologie, Hôpital Saint-Lazare, Paris.
B
B
Flourie
B
B
Messing
E
E
Bismuth
F
F
Etanchaud
F
F
Thuillier
J C
JC
Rambaud
D000140:Acidosis, Lactic / Q000097:blood / Q000150:complications*; D000328:Adult; D006801:Humans; D007421:Intestine, Small; D007773:Lactates / Q000097:blood; D008286:Malabsorption Syndromes / Q000150:complications*; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology; D013577:Syndrome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000627:therapeutic use; D014552:Urinary Tract Infections / Q000188:drug therapy
D007773:Lactates; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
Acidose D lactique et encéphalopathie au cours d'un syndrome du grêle court à l'occasion d'un traitement antibiotique.