A 63 year old man was admitted after a community cardiac arrest. He is currently day 5 post admission with uncertain neurological prognosis. He developed bilateral chest infiltrates yesterday and was started on Ampicillin/Clavulanic acid for a presumed nosocomial pneumonia. He has subsequently become progressively hypotensive requiring moderate dose noradrenaline, He is pyrexial 39.2C, he is anuric on dialysis and has an ALT495U/L (<40) and a blood glucose of 2.3 mmol/L (4 – 6).
a) List the likely causes of the pulmonary infiltrate.
b) List likely reasons for the raised ALT.
c) The patient has a plasma lactate of 6.2 mmol/L. What are the likely causes of the raised lactate in this patient?