# Ethylene Glycol Poisoning: A Case Study of a 71-Year-Old Male with a History of Alcohol Abuse and Suicide Attempts

## TL;DR

A 71-year-old man with alcohol abuse and suicide attempts died from severe ethylene glycol poisoning despite medical interventions.

## Contribution

This case study highlights the challenges and outcomes of managing ethylene glycol poisoning in a high-risk patient.

## Key findings

- Ethylene glycol poisoning was confirmed with a level of 226 despite negative serum alcohol levels.
- The patient developed progressive multi-organ failure requiring hemodialysis but ultimately succumbed to the poisoning.
- Fomepizole was used as primary treatment, while ethanol administration was avoided due to associated risks.

## Abstract

A 71-year-old male with a history of alcohol abuse and multiple suicide attempts was brought to the emergency department in an unconscious state. Initial assessment revealed profound obtundation and malnutrition. Laboratory findings demonstrated a significant anion gap metabolic acidosis with a high osmolar gap, suggestive of possible toxic alcohol ingestion. Despite negative serum alcohol levels, ethylene glycol poisoning was confirmed with a level of 226. Treatment included fluid resuscitation, bicarbonate therapy, and fomepizole administration. However, due to progressive multi-organ failure, continuous veno-venous hemodialysis was initiated. Despite interventions, the patient deteriorated rapidly, leading to a decision for hospice care, ultimately resulting in death. Ethylene glycol poisoning presents significant challenges in management, with potential complications including renal failure and multi-organ dysfunction. Fomepizole remains the cornerstone of treatment, but additional therapies such as ethanol administration were considered but ultimately deemed unnecessary due to associated risks. This case highlights the complexity and severity of ethylene glycol poisoning, emphasizing the need for early recognition and aggressive management strategies.