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Case Reports
. 2021 Mar;11(1):37-38.
doi: 10.1016/j.afjem.2020.10.011. Epub 2020 Nov 6.

Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis

Almien Smit  1 , Vidya Lalloo  1 , Andreas Engelbrecht  1
Affiliations
Case Reports

Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis

Almien Smit et al. Afr J Emerg Med. 2021 Mar.

Abstract

Introduction: 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.

Case report: We present a case of presumed ethylene glycol poisoning that presented with persistent seizures and a high anion gap metabolic acidosis (HAGMA).

Discussion: 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.

Keywords: Case report; Ethylene glycol poisoning; High anion gap metabolic acidosis; Status epilepticus; Toxic alcohols.

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Conflict of interest statement

The authors declare no conflict of interest.

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