RSS Feeds
Lactic Acidosis and AIDS
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TO THE EDITOR:
Chattha and associates [1] describe a group of seven human immunodeficiency virus (HIV)-infected patients with lactic acidosis in the absence of hypoxemia or another obvious cause. We suspect that sepsis may be the cause of lactic acidosis in many, if not all, of their patients. Several symptoms described in these patients, including nausea, anorexia, fever, malaise, and tachypnea, are typical of patients with sepsis.
The authors stated that they ruled out sepsis by appropriate laboratory tests and diagnostic procedures and by autopsy . Patients with HIV infection frequently have sepsis from occult or unusual infections that elude diagnosis by several diagnostic studies, including invasive biopsies. Blood cultures are positive in only about 50% of patients with clinical sepsis [2]. Normal values for oxygen delivery, consumption, and extraction do not exclude bacterial sepsis [3, 4] but may reflect an oxygen deficit because of increased oxygen demands and may contribute to lactic acid production.
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
Include no more than 300 words of text, three authors, and five references
Type with double-spacing
Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright 2004 by the American College of Physicians
