| Summary points: | A 31-year-old with history of uncontrolled asthma presents with cough with green sputum, wheezing, and shortness of breath over 3 days that did not respond to inhaled salbutamol and nebulised bronchodilation. This case report describes the patient's history, response to initial treatment, her course in hospital, and the outcome of final treatment. The authors discuss the possible pathogenesis of lactic acidosis in asthma. |