Zanoni Stephen, Carstairs Shaun, Darracq Michael A
Department of Emergency Medicine, Navy Medical Center San Diego, San Diego, California.
Division of Medical Toxicology, Department of Emergency Medicine, University of California, San Francisco, Fresno, California.
J Emerg Med. 2014 Jun;46(6):767-8. doi: 10.1016/j.jemermed.2013.11.125. Epub 2014 Mar 27.
The diagnosis of alcohol intoxication might not be considered in patients coming from locations where access to alcohol is severely restricted or not permitted.
We present a case of alcohol intoxication in a patient presenting from a military prison. The patient ingested an alcoholic beverage made in his prison cell with produce stolen from the prison cafeteria. We also discuss potential complications of "prison-brewed" alcoholic beverages.
A 22-year-old male presented to the emergency department after being found in his cell with a depressed level of consciousness and next to a mouthwash bottle filled with a foul-smelling liquid. Physical examination revealed a heart rate of 111 beats/min, a Glasgow Coma Scale score of 11, no signs of injury or track marks on the skin, and intermittent agitation alternating with somnolence. Laboratory evaluation was significant for a serum ethanol level of 279 mg/dL. After a period of observation, mental status returned to normal and the patient admitted to making "pruno."
Alcohol intoxication might be unexpected or not considered in patients that should have no access to common sources of ethanol. Awareness of methods of novel fermentation, even in incarcerated individuals, can assist in the differential diagnosis of patients presenting with altered mental status.
对于来自酒精获取受到严格限制或不被允许地区的患者，可能不会考虑酒精中毒的诊断。
我们报告一例来自军事监狱的酒精中毒病例。该患者饮用了用从监狱食堂偷来的食材在牢房自制的酒精饮料。我们还讨论了“监狱自酿”酒精饮料的潜在并发症。
一名22岁男性在牢房被发现意识水平下降，旁边有一个装满恶臭液体的漱口水瓶后被送往急诊科。体格检查显示心率为111次/分钟，格拉斯哥昏迷量表评分为11分，皮肤上无损伤或针眼迹象，且间歇性躁动与嗜睡交替。实验室检查显示血清乙醇水平为279mg/dL具有重要意义。经过一段时间观察，精神状态恢复正常，患者承认制作了“普诺酒”。
对于本不应接触常见乙醇来源的患者，酒精中毒可能出乎意料或未被考虑到。即使对于被监禁者，了解新型发酵方法有助于对出现精神状态改变的患者进行鉴别诊断。
