Diagnostic Challenges of Methanol Poisoning in Resource-Limited Settings: A Case Series

Methanol poisoning is a life-threatening emergency, but diagnosis is challenging in resource-limited settings lacking toxicology testing. This case series presents three cases of methanol poisoning: two patients with neurological symptoms and unexplained high anion gap metabolic acidosis were initially misdiagnosed as stroke or diabetic ketoacidosis and died after transfer, whereas the third patient received prompt empirical hemodialysis based on clinical suspicion and survived with full recovery. These cases illustrate that early recognition and empirical hemodialysis guided by clinical judgment, without confirmatory toxicology testing, can be life-saving in resource-constrained environments.