Long-term monitoring of D-lactic acidosis in a child.

A case of D-lactic acidosis in a 2 1/2-year-old child followed for 11 months is reported. The infant had previously undergone extensive small intestinal resection for midgut volvulus. Diagnosis was confirmed by measurement of plasma D-lactate. Metabolic acidosis, increased anion gap, ataxia, and lethargy in patients with small intestinal resection warrant investigation for D-lactic acidosis. The presumed etiology is absorption of D-lactic acid produced by bacterial fermentation of carbohydrate in the colon. Antibiotic treatment resulted in prompt resolution of symptoms in this case. Prospective and prolonged monitoring of acidosis in patients with small bowel resection is encouraged.