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Case Reports in Critical Care
Volume 2017, Article ID 5121032, 3 pages
Case Report

Thiamine Deficiency Leading to Refractory Lactic Acidosis in a Pediatric Patient

Section of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

Correspondence should be addressed to Alicia M. Teagarden; ude.iupui@sonarga

Received 10 July 2017; Accepted 7 September 2017; Published 8 October 2017

Academic Editor: Ricardo Oliveira

Copyright © 2017 Alicia M. Teagarden 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.


Thiamine plays a critical role in energy metabolism. Critically ill children and adults may develop thiamine deficiency with ultimately increased mortality due to potentially irreversible consequences of severe type B lactic acidosis. We report a case of an unvaccinated term neonate with malignant pertussis requiring extracorporeal membrane oxygenation and continuous renal replacement therapy, who developed profound lactic acidosis of unknown etiology. After countless evaluations for likely causes, the patient was ultimately determined to have thiamine deficiency and her acidosis resolved rapidly with vitamin supplementation.