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Case Reports in Critical Care
Volume 2014 (2014), Article ID 214970, 4 pages
http://dx.doi.org/10.1155/2014/214970
Case Report

Complete Heart Block and Persistent Lactic Acidosis as an Initial Presentation of Non-Hodgkin Lymphoma in a Critically Ill Newly Diagnosed AIDS Patient

1Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Avenue, Suit No. 12 F, Bronx, NY 10457, USA
2Department of Medicine, Bronx Lebanon Hospital Center, 1650 Selwyn Avenue, Suit No. 10 C, Bronx, NY 10457, USA
3Department of Pathology, Bronx Lebanon Hospital Center, 1650 Selwyn Avenue, Suit No. 10 C, Bronx, NY 10457, USA

Received 1 June 2014; Revised 13 October 2014; Accepted 19 October 2014; Published 6 November 2014

Academic Editor: Claudius Diez

Copyright © 2014 Mohsin Ijaz et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 66-year-old male with newly diagnosed untreated acquired immunodeficiency syndrome (AIDS) presented with chronic nonspecific complaints of weakness, fatigue, myalgia, and weight loss. His initial EKG showed complete heart block necessitating temporary pacemaker placement. He had no previous history of cardiac disease. He was also found to have a persistent lactic acidosis and imaging studies showed abdominal lymphadenopathy. The patient underwent biopsy of these lymph nodes and was found to have diffuse large B-cell lymphoma. The hospital course was complicated by respiratory failure requiring mechanical ventilator support and cardiac arrest. Patient remained critically ill; he was not a candidate for chemotherapy and, after a month of hospitalization, he died. Lactic acidosis and heart block as an initial presentation of non-Hodgkin lymphoma in an AIDS patient are an unusual and unique presentation.