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A 78-year-old woman developed pyroglutamic acidosis causing high anion gap metabolic acidosis following concurrent administration of flucloxacillin and paracetamol [routes and dosages not stated; not all indications stated].
The woman presented to the local emergency department with back pain, headache and general malaise for four days. After performing a septic screen, she started receiving therapy with flucloxacillin and gentamicin for presumed sepsis. Her blood cultures were positive for Staphylococcus aureus. Further workup revealed spondylodiscitis and infective endocarditis on the mitral...