Pyroglutamic acidosis in the setting of Staphylococcus aureus bacteremia treated with flucloxacillin-An uncommon cause of high anion gap metabolic acidosis

Pyroglutamic acidosis (PGA) or 5-Oxoprolinuria is an uncommon and often overlooked cause of high anion gap metabolic acidosis (HAGMA). This case highlights the importance of systematically approaching HAGMA, and to consider PGA as a differential diagnosis when medications that disrupt the γ-glutamyl cycle such as flucloxacillin and paracetamol are present.