Fatal methanol poisoning due to massive windshield screen washer fluid ingestion - case report

Urszula Fałkowska, Agnieszka Radzka, Aleksander Sławiński, Aleksander Ryczkowski, Małgorzata Neścior, Michał Tchórz

Abstract


Methanol is a toxic alcohol that can imitate ethanol in smell and taste. It has many household and industrial applications but can also be present in informally-produced alcoholic beverages. Methanol poisoning feature with high mortality and may be seen due to its intentional or unintentional ingestion. Metanol does not have significant intrinsic activity but its metabolites, especially format lead to severe metabolic acidosis, visual disturbances and neurological deficit. Diagnosis is mainly based upon the typical clinical course, metabolic acidosis with high osmolar gap and detection of methanol in plasma or urine. Recent guidelines recommend therapy using the competitive alcohol dehydrogenase inhibitors - fomepizol or ethanol. In cases of severe poisoning hemodialysis should be considered.
We present a case of a 39-year-old male who was considered to Emergency Department due to consumed high amount of windshield washer fluid containing methanol. Intoxicated patient was unstable with respiratory insufficiency and consciousness impairment. Despite of implemented treatment - hemodialysis, ethanol infusion and active respiratory therapy - patient died on seventh day after admission to a hospital. Methanol poisonings feature with high mortality even when the best healthcare is provided. It depends mainly on a dose of ingested alcohol and delay in admission to a hospital.

Keywords


methanol poisoning; windshield washer fluid; multi-organ-failure

Full Text:

PDF

References


Moon C-S. Estimations of the lethal and exposure doses for representative methanol symptoms in humans. Annals of Occupational and Environmental Medicine. 2017;29:44.

Ashurst JV, Nappe TM. Toxicity, Methanol. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482121/

Hvoda KE, Urdal P, Jacobsen D. Increased serum formate in the diagnosis of methanol poisoning. J Anal Toxicol. 2005;29(6):586–588.

http://www.who.int/environmental_health_emergencies/poisoning/methanol_information.pdf

Ashurst JV, Nappe TM. Toxicity, Methanol. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482121/

Paasma R, Hovda KE, Jacobsen D. Methanol poisoning and long term sequelae – a six years follow-up after a large methanol outbreak. BMC Clinical Pharmacology. 2009;9:5. doi:10.1186/1472-6904-9-5.

Krakowiak A, Piekarska-Wijatkowska A, Kobza-Sindlewska K et al. Poisoning deaths in Poland: Types and frequencies reported in Łódź, Kraków, Sosnowiec, Gdańsk, Wrocław and Poznań during 2009-2013. Int J Occup Med Environ Health. 2017 Oct 6;30(6):897-908.

Zakharov S, Pelclova D, Urban P, Navratil T, Diblik P, Kuthan P et al. Czech mass methanol outbreak 2012: epidemiology, challenges and clinical features. Clin Toxicol (Phila). 2014 Dec;52(10):1013-246.

The Minister. Ordinance of 25 September, 2013 issued by the Minister of National Economy, amending the ordinance on the control of production, marketing and use of dangerous or hazardous substances and mixtures, and marketing or use of products containing such substances or mixtures. [Internet] Sept 2013 [cited 2018 September 10]. Available from: http:// isap.sejm.gov.pl/DetailsServlet?id=WDU20130001173. Polish

Aisa TM, Ballut OM. Methanol intoxication with cerebral hemorrhage. Neurosciences. 2016;21(3):275-277. doi:10.17712/nsj.2016.3.20150592.

Liu JJ, Daya MR, Carrasquillo O, Kales SN. Prognostic factors in patients with methanol poisoning. J Toxicol Clin Toxicol. 1998;36(3):175-81.

Barceloux DG, Bond GR, Krenzelok EP, Cooper H, Vale JA. American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning. J Toxicol Clin Toxicol. 2002;40(4):415-46.

Casavant M. Fomepizole in the Treatment of Poisoning. Pediatrics. 2011; 107.170. 10.1542/peds.107.1.170.




DOI: http://dx.doi.org/10.5281/zenodo.1419724

Refbacks

  • There are currently no refbacks.




Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

https://pbn.nauka.gov.pl/sedno-webapp/search?search&searchCategory=WORK&filter.inJournal=36616

POL-index 2011 - 2014

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-32a319c5-a850-4f44-ba70-1418a6087655

BASE 2011 - 2014

https://www.base-search.net/Search/Results?lookfor=Journal+of+Health+Sciences+%28Radom%29&type=all&oaboost=1&ling=1&name=&thes=&refid=dcrespl&newsearch=1

http://elibrary.ru/contents.asp?titleid=37467

http://journal.rsw.edu.pl/index.php/JHS/issue/archive

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

https://www.ncbi.nlm.nih.gov/nlmcatalog/101679844

Find a library that holds this journal: http://worldcat.org/issn/23918306

Journal Language(s): English 

PBN Poland

https://pbn.nauka.gov.pl/sedno-webapp/journals/49068

POL-index

https://pbn.nauka.gov.pl/polindex-webapp/browse/journal/journal-c39c8169-88d2-45db-9e7f-d948ce9981c4

BASE

https://www.base-search.net/Search/Results?join=AND&bool0[]=AND&lookfor0[]=2391-8306&type0[]=all&page=11&l=pl&oaboost=1&refid=dcpagepl

Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2  www.ukw.edu.pl Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy http://ojs.ukw.edu.pl/index.php/johs  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at https://dbh.nsd.uib.no/publiseringskanaler/erihplus/periodical/info?id=485984

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.

http://journals.indexcopernicus.com/Journal+of+Education+Health+and+Sport,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase Index.com.

Website: www.infobaseindex.com

Universal Impact Factor 1.78 for year 2012. (http://www.uifactor.org/AppliedJournals.aspx)

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (https://pbn.nauka.gov.pl/journals/36616)

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ) http://elibrary.ru/contents.asp?titleid=37467

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski

(http://www1.bg.us.edu.pl/bazy/czasopisma/czasop_full.asp?id=3595)