A 45-year-old man is brought in by EMS after being found unconscious by his partner. He is confused and agitated. His vital signs are a BP of 90/60 mm Hg, HR of 120 bpm, RR of 24/min, and T of 37.6°C. His laboratory findings include the following:
- Sodium: 125 mEq/L
- Chloride: 90 mEq/L
- Potassium: 3.2 mEq/L
- Bicarbonate: 24 mEq/L
- Blood urea nitrogen: 28 mg/dL
- Creatinine: 1.0 mg/dL
- Ethanol: 322 mg/dL
- Glucose: 72 mg/dL
- Osmolality: 350 mOsm/kg
- Venous blood gas: pH 7.36, PCO2 45 mm Hg, PO2 95 mm Hg
- Urinalysis: 4+ ketones
Which of the following is most consistent with this patient’s presentation?
- Ethanol and isopropyl alcohol intoxication
- Ethanol intoxication only
- Ethylene glycol and ethanol intoxication
-
Methanol and ethanol intoxication
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References
- Kraut JA, Mullins ME. Toxic alcohols. N Engl J Med. 2018;378(3):270–280. https://www.nejm.org/doi/10.1056/NEJMra1615295
- Lima R. Toxic alcohols. NUEM blog website. Accessed March 27, 2023. https://www.nuemblog.com/blog/toxic-alcohols
Post Peer Reviewed By: Salim R. Rezaie, MD (Twitter: @srrezaie)
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