Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports

Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports

Toxic alcohol poisoning can be lethal if not identified early and treated appropriately. Toxic alcohol assays are often unavailable in low-resource setting, so clinicians have to infer a diagnosis based on suspicion, repeated evaluation and biochemical course. We report a case of toxic alcohol poiso...

Full description

Bibliographic Details
Main Authors: Micah Heldeweg, Louisa Kluijver, Kenrick Berend
Format: Article
Language:English
Published: SMC MEDIA SRL 2021-08-01
Series:European Journal of Case Reports in Internal Medicine
Subjects:
toxic alcohols
anion gap
osmolal gap
doctor delay
Online Access:https://www.ejcrim.com/index.php/EJCRIM/article/view/2751
id doaj-50641b8401a14e9497947f95ecea69b1
record_format Article
spelling doaj-50641b8401a14e9497947f95ecea69b12021-09-03T07:45:25ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942021-08-0110.12890/2021_0027512367Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case ReportsMicah Heldeweg0https://orcid.org/0000-0001-7420-8486Louisa Kluijver1Kenrick Berend2Department of Intensive Care, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands Department of Internal Medicine, Alrijne Hospital, Leiden, the NetherlandsDepartment of Internal Medicine, Curaçao Medical Center, CuraçaoToxic alcohol poisoning can be lethal if not identified early and treated appropriately. Toxic alcohol assays are often unavailable in low-resource setting, so clinicians have to infer a diagnosis based on suspicion, repeated evaluation and biochemical course. We report a case of toxic alcohol poisoning concealed by auto-intoxication with in-hospital hand sanitizer. The eventual appearance of a concurrent high anion gap prompted dialysis. In another case, a comatose patient presented with a high osmolal gap and a high anion gap. Incorrect a priori opinions caused us to defer dialysis and the patient died shortly afterwards. Clinicians should be aware that toxic alcohol poisoning can produce a confusing diagnostic picture with an insidious course, and that doctor delay can prove fatal.https://www.ejcrim.com/index.php/EJCRIM/article/view/2751toxic alcoholsanion gaposmolal gapdoctor delay
collection DOAJ
language English
format Article
sources DOAJ
author Micah Heldeweg
Louisa Kluijver
Kenrick Berend
spellingShingle Micah Heldeweg
Louisa Kluijver
Kenrick Berend
Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports
European Journal of Case Reports in Internal Medicine
toxic alcohols
anion gap
osmolal gap
doctor delay
author_facet Micah Heldeweg
Louisa Kluijver
Kenrick Berend
author_sort Micah Heldeweg
title Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports
title_short Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports
title_full Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports
title_fullStr Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports
title_full_unstemmed Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports
title_sort intoxication by hand-sanitizers and other toxic alcohols in a low-resource setting: two case reports
publisher SMC MEDIA SRL
series European Journal of Case Reports in Internal Medicine
issn 2284-2594
publishDate 2021-08-01
description Toxic alcohol poisoning can be lethal if not identified early and treated appropriately. Toxic alcohol assays are often unavailable in low-resource setting, so clinicians have to infer a diagnosis based on suspicion, repeated evaluation and biochemical course. We report a case of toxic alcohol poisoning concealed by auto-intoxication with in-hospital hand sanitizer. The eventual appearance of a concurrent high anion gap prompted dialysis. In another case, a comatose patient presented with a high osmolal gap and a high anion gap. Incorrect a priori opinions caused us to defer dialysis and the patient died shortly afterwards. Clinicians should be aware that toxic alcohol poisoning can produce a confusing diagnostic picture with an insidious course, and that doctor delay can prove fatal.
topic toxic alcohols
anion gap
osmolal gap
doctor delay
url https://www.ejcrim.com/index.php/EJCRIM/article/view/2751
work_keys_str_mv AT micahheldeweg intoxicationbyhandsanitizersandothertoxicalcoholsinalowresourcesettingtwocasereports
AT louisakluijver intoxicationbyhandsanitizersandothertoxicalcoholsinalowresourcesettingtwocasereports
AT kenrickberend intoxicationbyhandsanitizersandothertoxicalcoholsinalowresourcesettingtwocasereports
_version_ 1717817569573863424

Similar Items