Alcoholic ketoacidosis in an 11-year-old boy

A history of ethanol consumption combined with vomiting, anion gap metabolic acidosis, and altered mental status is consistent with a broad differential diagnosis, which requires a systematic approach. Alcoholic ketoacidosis is rare after binge drinking in the naïve individual and typically occurs in patients with heavy, chronic use. We present the case of an 11-year-old boy with acute ethanol intoxication and a clinical course that is most consistent with alcoholic ketoacidosis. Alcoholic ketoacidosis should be considered in the differential diagnosis of children with unexplained ketoacidosis when there is history or evidence of ethanol consumption combined with the appropriate clinical presentation.