Kabli Abdulghani O, Felemban Abdullah M, Nasri Alanoud K, Aljedani Faisal A, Bedairi Ahmed M, Alghamdi Mohammed M, Alghamdi Abdullah S, Ogran Saeed Y
Intensive Care Unit, King Fahad General Hospital, Jeddah, SAU.
Internal Medicine, Dr. Soliman Fakeeh Hospital (DSFH), Jeddah, SAU.
Cureus. 2023 Jun 28;15(6):e41108. doi: 10.7759/cureus.41108. eCollection 2023 Jun.
Introduction Methanol poisoning is an acute medical emergency. If not recognized in time and treated properly, it can lead to a considerable magnitude of morbidity as well as mortality. This article aims to report cases of methanol toxicity, focusing on clinical presentation, management, and outcomes. Method Nine ICU-admitted patients with confirmed positive serum methanol levels were analyzed in a case series at King Fahad General Hospital in Jeddah, Saudi Arabia, between November 2022 and January 2023. Results Among the nine patients admitted to the ICU due to methanol poisoning, the majority were middle-aged males, with two females included. Gastrointestinal symptoms were seen in two-thirds of patients, while three patients required immediate mechanical ventilation due to a low Glasgow Coma Scale. Severe metabolic acidosis was observed in most cases. All patients received sodium bicarbonate and hemodialysis, with six patients also receiving fomepizole. However, two patients in the study with low initial low Glasgow Coma Scale (GCS), severe metabolic acidosis, and diffuse brain edema, did not survive. One patient reported acute complete vision loss. Conclusion This case series highlights the importance of promptly recognizing and managing methanol toxicity in ICU settings. The clinical presentation of methanol toxicity can be challenging, and early diagnosis and treatment are crucial to prevent irreversible damage.
引言 甲醇中毒是一种急性医疗紧急情况。如果不能及时识别并妥善治疗，它会导致相当程度的发病率和死亡率。本文旨在报告甲醇中毒病例，重点关注临床表现、治疗和结果。方法 2022年11月至2023年1月期间，在沙特阿拉伯吉达法赫德国王总医院对9例血清甲醇水平确诊为阳性且入住重症监护病房（ICU）的患者进行了病例系列分析。结果 在因甲醇中毒入住ICU的9例患者中，大多数为中年男性，包括2名女性。三分之二的患者出现胃肠道症状，3例患者因格拉斯哥昏迷量表评分低而需要立即进行机械通气。大多数病例观察到严重代谢性酸中毒。所有患者均接受了碳酸氢钠和血液透析治疗，6例患者还接受了甲吡唑治疗。然而，该研究中有2例初始格拉斯哥昏迷量表评分低、严重代谢性酸中毒和弥漫性脑水肿的患者未能存活。1例患者报告急性完全失明。结论 该病例系列突出了在ICU环境中及时识别和管理甲醇中毒的重要性。甲醇中毒的临床表现可能具有挑战性，早期诊断和治疗对于预防不可逆损伤至关重要。
