Management of alcohol poisoning

2016 ◽  
Author(s):  
Knut Erik Hovda ◽  
Dag Jacobsen
Keyword(s):  
Metabolic Acidosis ◽  
Ethylene Glycol ◽  
Delayed Diagnosis ◽  
Unknown Origin ◽  
Symptomatic Treatment ◽  
Toxic Metabolite ◽  
Adequate Treatment ◽  
Alcohol Poisoning ◽  
Long Term Prognosis

Ethyl alcohol poisoning is by far the most common alcohol poisoning, and it can usually be handled by simple symptomatic treatment. Methanol and ethylene glycol poisonings share many characteristics, often presenting with a metabolic acidosis of unknown origin. Obtaining the diagnosis could be difficult, and assays for the toxic alcohol are seldom available at hand. The diagnosis should thus be supported by the use of the anion- and osmolal gaps, and/or a simple and specific formate enzymatic method measuring the toxic metabolite itself. A delayed diagnosis of poisonings will often have fatal consequences, in spite of effective treatment available. Treatment mainly consists of buffer, antidote, haemodialysis, and folinic acid (if methanol is suspected) in addition to supportive care. The long-term prognosis of cerebral (unless hypoxic damage)—and kidney function in ethylene glycol poisonings - is good given adequate treatment. Diethylene glycol is also highly toxic, but the knowledge on toxicity is limited. We recommend treatment similar to ethylene glycol poisonings. Other alcohol poisonings are less severe, and will usually present without pronounced metabolic acidosis.

scholarly journals Lactate Gap: A Diagnostic Support in Severe Metabolic Acidosis of Unknown Origin

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Linn E. Hauvik ◽  
Mercy Varghese ◽  
Erik W. Nielsen
Keyword(s):  
Metabolic Acidosis ◽  
Ethylene Glycol ◽  
Point Of Care ◽  
Unknown Origin ◽  
Medical Emergency ◽  
Severe Metabolic Acidosis ◽  
Ethylene Glycol Poisoning ◽  
The Difference ◽  
Lactate Levels ◽  
Elevated Lactate

Ethylene glycol poisoning is a medical emergency. The metabolites glycolate and glyoxylate give metabolic acidosis. Because of similar structure, these metabolites are misinterpreted as lactate by many point-of-care blood gas analyzers. The falsely high lactate values can lead to misdiagnosis, inappropriate laparotomies, and delayed antidotal therapy. As laboratory analyzers measure plasma lactate only, the difference or the “lactate gap” aids in early diagnosis. We present a patient with severe metabolic acidosis and elevated lactate levels on the point-of-care analyzer. A lactate gap supported the diagnosis of ethylene glycol poisoning. Hemodialysis and fomepizole treatment could be started immediately.

scholarly journals Long-Term Follow-Up of SAPHO Syndrome for 15 Years Led to a Diagnosis of Temporomandibular Joint Pain and Trismus

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Koki Takamatsu ◽  
Hitoshi Sato ◽  
Takashi Moriya ◽  
Arisa Yasuda ◽  
Takaaki Kamatani ◽  
...  
Keyword(s):  
Temporomandibular Joint ◽  
Systemic Disease ◽  
Symptomatic Treatment ◽  
Sapho Syndrome ◽  
Sterile Inflammation ◽  
Long Term Follow Up ◽  
Tmj Pain ◽  
Long Term Prognosis

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a systemic disease with symptoms of pustular skin disease and sterile osteoarticular lesions. This disease rarely involves the temporomandibular joint (TMJ). Although it is a disease with a good long-term prognosis, its treatment remains challenging. We describe a case with long-term follow-up of SAPHO syndrome for 15 years in which TMJ pain and trismus led to the diagnosis. A 30-year-old woman with TMJ pain and trismus was referred to our department. Her medical history included palmoplantar pustulosis. Sterile inflammation in the left TMJ and diffuse sclerosing osteomyelitis of the mandible were observed. Thus, she was diagnosed with SAPHO syndrome. The symptoms of severe TMJ pain, trismus, and left cheek swelling presented three times in the 15 years. Symptomatic treatment with nonsteroidal anti-inflammatory drugs, antibiotics, corticosteroids, and bisphosphonates was administered several times. There has been no relapse of symptoms over the past nine years. The patient must be continuously kept under observation to look for the relapse of symptoms.

Long-term prognosis of patients undergoing electrophysiologic studies for syncope of unknown origin

1988 ◽  
Vol 62 (17) ◽  
pp. 1186-1191 ◽  
Author(s):  
Eric B. Bass ◽  
James J. Elson ◽  
Richard N. Fogoros ◽  
Jacqueline Peterson ◽  
Vincent C. Arena ◽  
...  
Keyword(s):  
Unknown Origin ◽  
Long Term Prognosis ◽  
Electrophysiologic Studies

scholarly journals Long-term prognosis, treatment, and outcome of patients with fever of unknown origin in whom no diagnosis was made despite extensive investigation

Medicine ◽  
2018 ◽  
Vol 97 (25) ◽  
pp. e11241 ◽  
Author(s):  
Catharina M. Mulders-Manders ◽  
Celeste Engwerda ◽  
Anna Simon ◽  
Jos W.M. van der Meer ◽  
Chantal P. Bleeker-Rovers
Keyword(s):  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Extensive Investigation ◽  
Long Term Prognosis

scholarly journals Delayed Diagnosis of Rare Cyanotic Cardiac Lesion in A Hypoxemic but otherwise Asymptomatic Infant

2020 ◽  
Vol 26 (2) ◽  
pp. 68-75
Author(s):  
Dayang Zuraini Sahadan ◽  
Ee Wei Ng ◽  
Yinn Khurn Ooi
Keyword(s):  
Superior Vena ◽  
Delayed Diagnosis ◽  
Vena Cava ◽  
Venous Drainage ◽  
Supplemental Oxygen ◽  
Systemic Embolization ◽  
Anomalous Systemic Venous Drainage ◽  
Long Term Prognosis ◽  
Asymptomatic Infant

The causes of neonatal hypoxemia are usually either pulmonary or cardiac pathologies. We report a case of a 2-month-old boy with oxygen dependency since birth. He would desaturate down to 88-90% whenever supplemental oxygen was weaned off. Initial screening echocardiograms described only a small atrial septal defect, thus lung disease was thought to be the aetiology. Eventually, a detailed echocardiogram and CT angiography revealed anomalous right superior vena cava (RSVC) draining into the left atrium (LA). Echocardiography with bubble study injected via the upper extremities showed brisk filling of “bubbles” in the left heart, confirming fixed right-to-left shunting. Anomalous RSVC drainage into the LA is an extremely rare form of anomalous systemic venous drainage whereby unexplained hypoxemia is present and is sometimes the only clinical manifestation. Surgical correction of this anomaly is indicated to prevent complications of cyanosis and risk of systemic embolization. The surgery generally carries low risk and is associated with good long-term prognosis.

scholarly journals Case Report: Mineralized Pulmonary Artery Thrombi in Two Dogs Treated for Meningoencephalitis of Unknown Origin

2020 ◽  
Vol 7 ◽  
Author(s):  
Suzanne Rosen ◽  
Leontine Benedicenti ◽  
Scott Petesch ◽  
Jennifer Reetz ◽  
Evelyn Marie Galban
Keyword(s):  
Case Report ◽  
Adverse Effects ◽  
Pulmonary Artery ◽  
Survival Time ◽  
Cytosine Arabinoside ◽  
Pulmonary Arteries ◽  
Case Series ◽  
Unknown Origin ◽  
Long Term Prognosis

Meningoencephalitis of unknown origin (MUO) is a relatively common and very serious canine neurologic condition, which is typically associated with a poor long term prognosis despite treatment. This case series chronicles two dogs diagnosed with MUO who were treated with long term corticosteroids and cytosine arabinoside and lived well-beyond the typical survival time for this condition. Both eventually succumbed to respiratory signs associated with mineralized thrombi in their pulmonary arteries. Adverse effects from the two drugs used for treatment are reviewed in order to propose a possible mechanism to explain how long term use of these medications could result in such a phenomenon.

Sign in / Sign up

Export Citation Format

Share Document