Flourie B, Messing B, Bismuth E, Etanchaud F, Thuillier F, Rambaud J C
Service de Gastroentérologie, Hôpital Saint-Lazare, Paris.
Gastroenterol Clin Biol. 1990;14(6-7):596-8.
A 24 year-old patient with a short-bowel syndrome receiving home parenteral nutrition in addition to oral feeding for 32 months was treated by oral trimethoprim-sulfamethoxazole for urinary tract infection. Three days later, he developed neurologic disorders associated with severe hyperchloremic acidosis and high plasma level of D-lactate. This is a rare complication of intestinal malabsorption due to small bowel by-pass or extensive resection due to transient alteration of intestinal microflora induced by the oral antibiotic treatment. Diagnosis requires a high indice of suspicion.
一名24岁的短肠综合征患者，除经口喂养外还接受了32个月的家庭肠外营养，因尿路感染接受口服甲氧苄啶-磺胺甲恶唑治疗。三天后，他出现了与严重高氯性酸中毒和高血浆D-乳酸水平相关的神经功能障碍。这是小肠旁路或广泛切除导致肠道吸收不良的一种罕见并发症，是由口服抗生素治疗引起的肠道微生物群短暂改变所致。诊断需要高度怀疑。
