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Survival with extremely high blood methanol concentration
P Hantson1, V Haufroid, P Mahieu
1Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, Brussels, Belgium.
Summary
Aggressive treatment can save lives even with severe methanol poisoning. Prompt intervention, including fomepizole or ethanol and dialysis, is crucial for managing high methanol blood levels and preventing fatalities.
Area of Science:
- Toxicology
- Emergency Medicine
- Metabolic Disorders
Background:
- Methanol poisoning remains a significant cause of mortality.
- Methanol is metabolized to toxic formic acid, leading to severe acidosis and organ damage.
Observation:
- A 27-year-old male presented with a peak blood methanol concentration of 12.9 g/l, 22 hours post-ingestion.
- The patient exhibited symptoms consistent with severe methanol toxicity.
Findings:
- Aggressive treatment, including metabolic acidosis correction, ethanol infusion, and dialysis (hemodialysis and peritoneal dialysis), facilitated survival.
- Despite treatment, the patient experienced moderate visual sequelae and esophageal stenosis.
Implications:
- This case highlights that survival is achievable even with extremely high methanol blood levels.
- Effective management strategies are critical for mitigating the toxicity of methanol and its metabolites.