Acute kidney injury secondary to severe metabolic acidosis combined with hyperlactatemia caused by amoxicillin:a case report
Objective A case of severe metabolic acidosis combined with hyperlactatemia secondary acute kidney injury in a female patient after oral amoxicillin was analyzed to provide reference for clinical use.Methods The clinical characteristics,relevant examination and treatment plan of the patient were reviewed,and medication recommendations were put forward.Results One day after taking amoxicillin(2 g)orally,the patient developed mental changes,progressive exac-erbation,and disturbance of consciousness.Blood gas analysis suggested severe metabolic acidosis combined with hyperlac-tatemia.The correlation score of Naranjo's adverse drug reactions of amoxicillin was 6 points(possibly related),the patient's severe metabolic acidosis and hyperlactatemia were"likely"caused by oral amoxicillin capsules,and acute kidney injury was secondary to severe acidosis.After treatment,the patient's condition quickly reversed and was discharged from hospital for 1 week.Conclusion When unexplained changes occur in patients treated with amoxicillin,relevant tests should be per-formed immediately to rule out life-threatening adverse reactions such as severe metabolic acidosis and kidney failure.For amoxicillin related severe metabolic acidosis,it is necessary to fully evaluate and initiate continuous blood purification thera-py if necessary to prevent further deterioration of the disease and improve the prognosis.
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