Clinical QuickieInfectious Disease
Lactate — Elevated Lactate ≠ Automatically Sepsis
Lactate reflects altered production and/or clearance — not a single diagnosis.
Think beyond shock
Beta-agonists, seizures, severe exertion, liver dysfunction, malignancy and medications can raise lactate without classic septic shock.
Context + trajectory matter
A mildly elevated stable lactate in a clinically well patient is different from a rising lactate with hypotension and poor perfusion.
Clearance can be impaired
The liver is central to lactate metabolism; hepatic dysfunction can prolong elevation.
Do not treat the number alone
Identify perfusion problems, hypoxemia, seizures, adrenergic drivers, medications and underlying disease rather than chasing normalization.
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