Linezolid-Induced Lactic Acidosis Sets Stage for Surgery to Rule Out Mesenteric Ischemia: A Case Report

A A Pract. 2018 Aug 15;11(4):93-95. doi: 10.1213/XAA.0000000000000751.


An 81-year-old woman with extensive peripheral vascular and coronary artery disease was admitted to the intensive care unit with a deep heel abscess and urinary tract infection. When cultures from the heel ulcer yielded vancomycin-resistant enterococci, she was started on the antibiotic linezolid. After several days of intravenous linezolid therapy, she developed severe lactic acidosis (pH 6.89) and elevation of pancreatic enzymes. An emergent exploratory laparotomy was performed to rule out mesenteric ischemia. Findings from the laparotomy were negative, and after elimination of other differential diagnoses, the metabolic acidosis was ultimately attributed to linezolid. Acidosis resolved after discontinuation of linezolid.

Publication types

  • Case Reports

MeSH terms

  • Abscess / drug therapy*
  • Acidosis, Lactic / chemically induced*
  • Acidosis, Lactic / surgery
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects*
  • Drug Resistance, Bacterial
  • Escherichia coli Infections / drug therapy*
  • Female
  • Humans
  • Laparotomy
  • Linezolid / adverse effects*
  • Mesenteric Ischemia / diagnosis
  • Skin Diseases / drug therapy*
  • Urinary Tract Infections / drug therapy*


  • Anti-Bacterial Agents
  • Linezolid