Fatal lactic acidosis during antiretroviral therapy.
OBJECTIVE
To describe the first pediatric case of fatal lactic acidosis in an antiretroviral-treated child with human immunodeficiency virus (HIV) infection.


METHODS
Case report.


METHODS
Pediatric intensive care unit.


METHODS
A patient with fatal antiretroviral therapy-associated type B lactic acidosis.


METHODS
None.


RESULTS
We report the case of a 5-yr-old girl with HIV infection, receiving ritonavir, stavudine, and didanosine, who presented with a 10-day history of nausea and vomiting. Severe lactic acidosis was found. Her clinical condition worsened, with progressive increase in serum lactate, despite aggressive supportive therapy, including intravenous alkali and continuous arteriovenous hemodiafiltration.


CONCLUSIONS
Fatal lactic acidosis is a complication of antiretroviral therapy in pediatric HIV patients, which has not been previously reported in children. Early recognition of mitochondrial dysfunction in these patients could prevent the development of fatal lactic acidosis.
Rey
Corsino
C
Pediatric Intensive Care Unit, Department of Pediatrics, Hospital Universitario Central de Asturias, University of Oviedo, Oviedo, Spain. crey@hcas.sespa.es
Prieto
Soledad
S
Medina
Alberto
A
Pérez
Carlos
C
Concha
Andrés
A
Menéndez
Sergio
S
D000140:Acidosis, Lactic / Q000139:chemically induced*; D002675:Child, Preschool; D016049:Didanosine / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000009:adverse effects*; D006801:Humans; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D019438:Ritonavir / Q000009:adverse effects*; D018119:Stavudine / Q000009:adverse effects*
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D018119:Stavudine; D016049:Didanosine; D019438:Ritonavir