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Methanol outbreak: a Malaysian tertiary hospital experience.
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- Author(s): Md Noor, J.; Hawari, R.; Mokhtar, M. F.; Yussof, S. J.; Chew, N.; Norzan, N. A.; Rahimi, R.; Ismail, Z.; Singh, S.; Baladas, J.; Hashim, N. H.; Mohamad, M. I. K.; Pathmanathan, M. D.
- Source:
International Journal of Emergency Medicine; 2/7/2020, Vol. 13 Issue 1, p1-7, 7p, 3 Charts, 3 Graphs- Subject Terms:
ACID-base equilibrium; BICARBONATE ions; DISEASES; DRUG toxicity; DISEASE outbreaks; ETHANOL; HEMODIALYSIS; HOSPITAL emergency services; HYDROGEN-ion concentration; IMMIGRANTS; INTRAVENOUS therapy; LACTATES; MEDICAL referrals; METHANOL; NEUROLOGICAL disorders; OPTIC nerve diseases; POTASSIUM; SURVIVAL analysis (Biometry); UVEITIS; VISION disorders; COMMUNICATION barriers; DISCHARGE planning; RETROSPECTIVE studies; SEVERITY of illness index; OSMOLAR concentration; TERTIARY care; DISEASE risk factors; ADULTS - Source:
- Additional Information
- Subject Terms:
- Abstract: Introduction: Methanol poisoning usually occurs in a cluster and initial diagnosis can be challenging. Mortality is high without immediate interventions. This paper describes a methanol poisoning outbreak and difficulties in managing a large number of patients with limited resources. Methodology: A retrospective analysis of a methanol poisoning outbreak in September 2018 was performed, describing patients who presented to a major tertiary referral centre. Result: A total of 31 patients were received over the period of 9 days. Thirty of them were males with a mean age of 32 years old. They were mostly foreigners. From the 31 patients, 19.3% were dead on arrival, 3.2% died in the emergency department and 38.7% survived and discharged. The overall mortality rate was 61.3%. Out of the 12 patients who survived, two patients had toxic optic neuropathy, and one patient had uveitis. The rest of the survivors did not have any long-term complications. Osmolar gap and lactate had strong correlations with patient's mortality. Serum pH, bicarbonate, lactate, potassium, anion gap, osmolar gap and measured serum osmolarity between the alive and dead patients were significant. Post-mortem findings of the brain were unremarkable. Conclusion: The mortality rate was higher, and the morbidity includes permanent visual impairment and severe neurological sequelae. Language barrier, severity of illness, late presentation, unavailability of intravenous ethanol and fomipezole and delayed dialysis may have been the contributing factors. Patient was managed based on clinical presentation. Laboratory parameters showed difference in median between group that survived and succumbed for pH, serum bicarbonate, lactate, potassium and osmolar and anion gap. Management of methanol toxicity outbreak in resource-limited area will benefit from a well-designed guideline that is adaptable to the locality. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of International Journal of Emergency Medicine is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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