Caffeine poisoning and lactate rise: an overlooked toxic effect?

Severe caffeine poisoning is rare but associated with a high mortality. The symptoms are mainly attributable to hyperadrenergic stimulation, are relatively well known and described in the literature. Transient rises in plasma lactate levels may occur but are, however, less well described. We present a case of serious caffeine poisoning with a concomitant rise in lactate treated with a non-selective beta-blocker and discuss briefly the symptomatology, the management of caffeine poisoning and the association between lactate and metabolic acidosis.