Linezolid-Induced Lactic Acidosis Presenting As Acute Cholecystitis: A Case Report and Systematic Review
Abstract
Linezolid has gained increased use for the treatment of infections caused by multidrug-resistant Gram-positive bacteria in recent years. It can cause rare but potentially life-threatening lactic acidosis. Here, we presented a case report of linezolid-induced lactic acidosis (LILA), along with a systematic review of current literature. The patient was a 55-year-old male who presented with the symptoms of acute cholecystitis. He had been treated for sepsis due to acute cholecystitis with broad-spectrum antibiotics and intravenous fluids as per protocol. Still, his lactate level was getting elevated. After excluding other causes of lactic acidosis, LILA was diagnosed, and linezolid was discontinued. His lactic acid level, as well as his physical condition, improved after that. Studies related to LILA were searched in Medline via PubMed. After screening titles, abstracts, and full texts, data were extracted, tabulated, and presented in this article. The risk of bias was also assessed. We found 78 relevant articles in the primary search, and 26 articles, including 496 patients, were included in the study. From 23 studies of 129 patients, 28 patients (21.7%) died in the setting of LILA. The peak lactate level in which the patient developed LILA was 38.1 mmol/L after four weeks of therapy. The most common health conditions associated with LILA were end-stage renal failure (ESRD), diabetes mellitus (DM), hypertension, chronic obstructive pulmonary disease (COPD), etc. Eighteen…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 496 participants or records.
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