Oral Ethanol for Methanol Poisoning: A Case Report

TL;DR

A man with methanol poisoning was successfully treated with oral ethanol when standard tests weren't available, showing early treatment can save lives.

Contribution

This case highlights the effectiveness of oral ethanol as an empirical treatment for methanol poisoning in resource-limited settings.

Findings

The patient's symptoms improved after receiving oral ethanol and hemodialysis.

Timely treatment based on clinical suspicion prevented severe neurological damage.

Blurred vision resolved within a day following treatment initiation.

Abstract

Methanol poisoning usually occurs due to accidental ingestion of distilling and fermenting errors or beverage contamination. The typical presentation includes visual disturbances with severe metabolic acidosis and neurological damage.

A 32-year-old male presented with blurring of vision for 2 days, with a history of local alcohol consumption 2 days prior, with severe metabolic acidosis on arterial blood gas analysis, and was clinically diagnosed and treated as methanol poisoning in the absence of a serum methanol assay. He responded favorably to the treatment with timely oral ethanol via Nasogastric tube (56 grams, 0.8 g/kg body weight) followed by hemodialysis. His bedside visual acuity was normal, and his complaint of blurred vision subsided on the following day of treatment. This case demonstrates that timely empirical treatment based on clinical suspicion can be life-saving in methanol poisoning, even in the absence of typical diagnostic markers or access to standard antidotal therapy.