Smit Almien, Lalloo Vidya, Engelbrecht Andreas
Emergency Centre, Steve Biko Academic Hospital, University of Pretoria, Pretoria 0084, South Africa.
Afr J Emerg Med. 2021 Mar;11(1):37-38. doi: 10.1016/j.afjem.2020.10.011. Epub 2020 Nov 6.
Due to the nationwide lockdown to mitigate the spread of COVID-19 and subsequent alcohol ban in South Africa, several cases of toxic alcohol ingestion presented to our emergency unit. Many of these patients admitted to making home brews of alcohol while others simply use industrial toxic alcohols. The diagnosis of these poisonings is challenging as direct assays are not available in our setting.
We present a case of presumed ethylene glycol poisoning that presented with persistent seizures and a high anion gap metabolic acidosis (HAGMA).
A high index of suspicion for toxic alcohol poisoning should be maintained in patients presenting with an altered mental status, seizures and a HAGMA. Indirect markers such as clinical features and laboratory results can lead to the diagnosis when direct assays are unavailable.
由于南非实施全国封锁以减缓新冠病毒的传播以及随后的禁酒令，多例有毒酒精摄入病例被送至我们的急诊科。这些患者中许多承认自制酒精，而其他一些人则单纯使用工业有毒酒精。由于我们所在地区无法进行直接检测，这些中毒的诊断具有挑战性。
我们报告一例疑似乙二醇中毒病例，该病例表现为持续性癫痫发作和高阴离子间隙代谢性酸中毒（HAGMA）。
对于出现精神状态改变、癫痫发作和HAGMA的患者，应高度怀疑有毒酒精中毒。当无法进行直接检测时，临床特征和实验室检查结果等间接指标可有助于诊断。
