Abstract: PO1490
Methanol Intoxication Secondary to Adulterated Cane Alcohol "El Chorrito"
Session Information
- Fluid, Electrolyte, and Acid-Base Disorders: Clinical - 2
October 22, 2020 | Location: On-Demand
Abstract Time: 10:00 AM - 12:00 PM
Category: Trainee Case Report
- 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical
Authors
- Font, Jorge Jaime, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Chavez, Jonathan, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Navarro gallardo, Joana Goretty, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Flores, Christian Perez, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Sánchez Villaseca, Sergio Jacob, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
- Yanowsky ortega, Ekatherina, Hospital Civil de Guadalajara Unidad Hospitalaria Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico
Introduction
Methanol intoxication is a rare and lethal form of poisoning that may cause severe anion gap and osmolar metabolic acidosis (MA), visual disturbances, neurological dysfunction and death. We present a group of seven unrelated cases with methanol intoxication from cities in southern Mexico of a total of 106 intoxicated patients and 43 deaths reported.
Case Description
Upon arrival to Hospital Civil of Guadalajara a group of seven patients presented with severe MA, high anion and osmolar gap, neurologic and visual deterioration ,respiratory failure requiring mechanical ventilation and hemodynamically unstable requiring vasopressor. Intake of methanol was accidental, since a batch of adulterated alcoholic bottles was identified and distributed by "El Chorrito" store. Methanol concentrations is not available in our hospital. CT Scan revealed hemorrhage in basal ganglia and white matter involvement in all of them. Fomepizole is not available in Mexico so an ethanol infusion with vodka was started. All patients initiated hemodialysis (HD) as soon as possible and all underwent at least two sessions. Acid base balance was restored but five (71%) of the seven patients died. The remaining two patients persist in critical conditions requiring mechanical ventilation, no neurologic response and vasopressor dependent.
Discussion
This case series illustrates the poor clinical outcomes suffered by patients with methanol poisoning and the limitations of our public health system. Unfortunately the time lapse upon arrival was prolonged and organ damage irreversible leading to mortality in the majority of the cases.