Lactic Acidosis in a Non-smoking Asthmatic Female: A Case of Salbutamol-Induced Elevated Lactate in the Context of Suspected Lower Respiratory Tract Infection

Lactic acidosis is typically associated with hypoperfusion states such as sepsis or shock; however, non-hypoxic mechanisms like beta-2 agonist therapy can also lead to lactic acidosis. We report the case of a 56-year-old female with asthma exacerbation who developed type B lactic acidosis following high-dose salbutamol administration. Clinical improvement and rapid normalisation of lactate after reducing bronchodilator use support the diagnosis of salbutamol-induced lactic acidosis (SILA). This report emphasises the importance of distinguishing SILA from more serious causes of hyperlactatemia, such as sepsis or pulmonary embolism.