Methanol poisoning as a result of inhalational solvent abuse

We report an unusual presentation of solvent abuse. A 17-year-old boy was brought to the emergency department after he inhaled fumes from a rag soaked with a carburetor cleaner containing toluene, methylene chloride, and methanol. Considered to be intoxicated from the acute effects of sniffing toluene or methylene chloride, the patient remained lethargic and ataxic despite removal from exposure and administration of supplemental oxygen. Subsequently, he was found to have a toxic serum methanol level (23 mg/dL). Toluene, methylene chloride, and methanol are widely used in industry and carry potential occupational risks for exposure. These agents are also found in many products available for home use. The toxicology and management of each of the agents in this exposure are discussed.