Methanol Poisoning Leading to Brain Death: A Case Report

Introduction The COVID-19 pandemic has put increased stress on medical systems, infrastructure, and the public in expected and unexpected ways. This case report summarises an unexpected case of methanol poisoning from hand sanitiser ingestion due to changes in industry regulations, increased demand for cleaning products and severe psychosocial stressors brought on by the pandemic. Severe methanol toxicity results in profound metabolic disturbances, damage to the retina and optic nerves, and potentially death. Case Presentation The patient was a 26-year-old male with alcohol use disorder who presented with one day of nausea, vomiting, and abdominal pain after consuming hand sanitiser. Within a few hours, the patient had suffered multiple seizures, cardiac arrests and required admission to the ICU for emergent management of methanol poisoning. EEG and brain perfusion imaging were performed to confirm brain death, given concerns about the cranial nerve exam after methanol poisoning. Conclusions While rare, methanol toxicity remains a potentially fatal poisoning in the United States and worldwide. When healthcare and public resources are strained, healthcare professionals must consider particularly abnormal presentations. In patients suspected of brain death from methanol toxicity, cranial nerve examination may be unreliable. Therefore, additional testing is necessary to confirm brain death.

Poisoning and envenoming

Acute poisoning?, Acute pesticide poisoning?, Organophosphates/carbamates?, Acute poisoning with pharmaceuticals/chemicals?, Mushroom poisoning?, Methanol poisoning?, Fish and shellfish poisoning?, Snake bite?, Scorpion sting?, Spider bite?, Fish stings?, Jelly fish stings?

Visual Disturbances in Patients With Acute Methanol Poisoning: A Cross-sectional Study

Background: Methanol poisoning is a serious problem in public health, especially in developing countries. The present study aimed to evaluate the incidence of visual disturbances in patients with acute methanol poisoning in the south of Iran. Methods: This cross-sectional study (from 21/March/2014 to 21/March/2019) was conducted on all adult patients’ medical records who were referred to Ali-Asghar Hospital in Shiraz City, Iran, with acute methanol poisoning. The required data were collected using a data-gathering form and were then analyzed. Results: Twenty male patients were enrolled in this research, with Mean±SD age of 33.15±10.40 years. Visual disturbances were observed in 15(75%) of the study subjects, as the most common clinical manifestations. Blurred vision (40%) and blindness (35%) were the most frequent visual disturbances in the study participants. None of the study subjects reported photophobia. The explored variables did not differ between patients with visual disturbances and those without visual disturbances. Only one patient who encountered blindness was expired. Conclusion: The incidence of visual disturbances in the study patients with acute methanol poisoning was higher than that of similar studies

The prognostic value of red cell distribution width for in-hospital mortality in patients with methanol poisoning

Aim Red blood cell distribution width (RDW) is a numerical measure of variability in the size of circulating erythrocytes and is routinely reported as a component of a complete blood count panel. It has been shown that higher RDW is associated with increased mortality and morbidity in several types of intoxication. This study was designed to evaluate the prognostic value of RDW for in-hospital mortality and need of invasive mechanical ventilation in patients with methanol poisoning. Methods A retrospective chart review of patients with methanol poisoning was performed using data from Adana City Training and Research Hospital obtained between January 2019 and January 2020. Patients’ demographics, clinical features, the time elapsed between ingestion and presentation, the treatment applied, blood gas analysis, laboratory measures including RDW on admission, and clinical outcome were obtained. Results A total of 42 patients with methanol poisoning were included in the study with a mean age of 45 ± 11 years. The overall mortality was 21.4%. Values of RDW on admission were significantly higher in non-survivors than in survivors. The area under the receiver operating curve of RDW was 0.778 (95% CI: 0.567–0.988) for predicting in-hospital mortality and 0.762 (95% CI: 0.592–0.932) for predicting mechanical ventilator requirement. Conclusion This study suggests that increased RDW on the first admission is associated with mortality and with mechanical ventilator requirement in patients with methanol poisoning.