ArticleCureus2026
A Rare Case of Pyroglutamic Acidosis After Cardiac Surgery.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Metabolic acidosis is a common finding following cardiac surgery. Although the differential diagnosis of high-anion-gap metabolic acidosis is well established, less common causes may be overlooked, making the diagnosis challenging. We report the case of a 59-year-old patient who developed high-anion-gap metabolic acidosis after surgical treatment for mediastinitis, caused by the concomitant use of flucloxacillin and paracetamol. This drug interaction disrupts the γ-glutamyl cycle, leading to the accumulation of 5-oxoproline (pyroglutamic acid). Although rare, this interaction may cause a severe and potentially fatal reaction, particularly in patients with renal failure, sepsis, or malnutrition. As such, the possible diagnosis of pyroglutamic acidosis should be kept in mind in these settings, and the use of these medications should be discontinued immediately.
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