Methanol Poisoning with Fatality- Case Series in Dhaka Medical College Hospital in Bangladesh

Abstract

Background: Adulterated methanol is highly toxic and leads to severe metabolic acidosis and blindness and mortality is very high if not treated with specific antidote. The time of ingestion and severity of illness is very short and comprehensive quick assessment and care is crucial for survival of patient. The selective antidote Fomepizole is not available in Bangladesh and pure intravenous ethanol is also out of reach in health care facility. The oral ethanol has its legislative regulation. Occasional clusters of severe methanol poisoning leading to fatality has been observed in recent years in Bangladesh. Here is a case series of 8 cases of adulterated methanol poisoning in a tertiary care hospital with lethality.

Outcome of Methanol Toxicity Outbreak In Saudi Arabia: Case Series Study

“…Nevertheless, all of the patients are Middle Ages. This finding is consistent with reports from other studies conducted in Saudi Arabia, as well as in other Arabic and Asian countries [3,[6][7][8][9][10][11]. It is possible that social and religious norms play a role in limiting female involvement in methanol poisoning.…”

“…Three patients had very disturbed consciousness levels with a Glasgow Coma Scale ranging from 4-11, which could be confusing for emergency physicians. Similar findings of rapid deterioration in consciousness have been reported in other studies, including a case report from Saudi Arabia, even brain dead after a toxic dose has been as well [ 10 , 14 - 15 ].…”

“…Two patients in our series with initial low GCS, severe metabolic acidosis, and diffuse cerebral edema died from methanol poisoning. These are poor prognostic factors that require prompt attention and early intervention [ 23 , 6 , 19 , 10 , 11 ].…”