Methanol Poisoning Leading to Brain Death: A Case Report

Abstract Introduction The COVID-19 pandemic has put increased stress on medical systems, infrastructure, and the public in expected and unexpected ways. This case report summarises an unexpected case of methanol poisoning from hand sanitiser ingestion due to changes in industry regulations, increased demand for cleaning products and severe psychosocial stressors brought on by the pandemic. Severe methanol toxicity results in profound metabolic disturbances, damage to the retina and optic nerves, and potentially death. Case Presentation The patient was a 26-year-old male with alcohol use disorder who presented with one day of nausea, vomiting, and abdominal pain after consuming hand sanitiser. Within a few hours, the patient had suffered multiple seizures, cardiac arrests and required admission to the ICU for emergent management of methanol poisoning. EEG and brain perfusion imaging were performed to confirm brain death, given concerns about the cranial nerve exam after methanol poisoning. Conclusions While rare, methanol toxicity remains a potentially fatal poisoning in the United States and worldwide. When healthcare and public resources are strained, healthcare professionals must consider particularly abnormal presentations. In patients suspected of brain death from methanol toxicity, cranial nerve examination may be unreliable. Therefore, additional testing is necessary to confirm brain death.

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Effects of intravascular laser phototherapy on delayed neurological sequelae after carbon monoxide intoxication as evaluated by brain perfusion imaging: A case report and review of the literature

World Journal of Clinical Cases ◽

10.12998/wjcc.v9.i13.3048 ◽

2021 ◽

Vol 9 (13) ◽

pp. 3048-3055

Author(s):

Chuan-Ching Liu ◽

Chun-Sheng Hsu ◽

Hsin-Chen He ◽

Yuan-Yang Cheng ◽

Shin-Tsu Chang

Keyword(s):

Carbon Monoxide ◽

Case Report ◽

Perfusion Imaging ◽

Brain Perfusion ◽

Review Of The Literature ◽

Neurological Sequelae ◽

Carbon Monoxide Intoxication ◽

Laser Phototherapy ◽

Brain Perfusion Imaging

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Unexpected preserved brain perfusion imaging despite severe and diffuse atherosclerosis of supra-aortic trunks : case report - online article

CardioVascular Journal of Africa ◽

10.5830/cvja-2013-009 ◽

2013 ◽

Vol 24 (3) ◽

pp. e12-e14 ◽

Cited By ~ 1

Author(s):

Guiseppe Gargiulo ◽

Fabio Tortora ◽

Mario Cirillo ◽

Cinzia Perrino ◽

Gabriele Giacomo Schiattarella ◽

...

Keyword(s):

Case Report ◽

Perfusion Imaging ◽

Brain Perfusion ◽

Brain Perfusion Imaging

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Complications of drowning: A case report

Paediatrica Indonesiana ◽

10.14238/pi59.5.2019.284-8 ◽

2019 ◽

Vol 59 (5) ◽

pp. 284-8

Author(s):

Felicia Anita Wijaya ◽

I Gde Doddy Kurnia Indrawan

Keyword(s):

United States ◽

Case Report ◽

Brain Damage ◽

The United States ◽

Accidental Death ◽

Common Cause ◽

Death By Drowning

Unintentional drowning is the sixth most common cause of accidental death, accounting for 4,086 deaths (1.4 per 100,000) in the United States in 2007.1 In children, drowning is the second leading cause of injury-related death, and those aged 1–3 years have the highest rate of drowning.2 More than 1,400 pediatric drownings were reported in the United States in 2008.3 Many drowning deaths are due to lack of supervision in the bathtub, unprotected access to a pool, or lack of swimming skills.3 For every death by drowning, six children are hospitalized for drowning, and up to 10% of survivors experience severe brain damage.2

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Paliperidone induced neutropenia in first episode psychosis: a case report

BMC Psychiatry ◽

10.1186/s12888-021-03073-w ◽

2021 ◽

Vol 21 (1) ◽

Cited By ~ 1

Author(s):

Natalie Martos ◽

William Hall ◽

Alicia Marhefka ◽

Thomas W. Sedlak ◽

Frederick C. Nucifora

Keyword(s):

Adverse Effect ◽

Case Report ◽

The United States ◽

First Episode Psychosis ◽

Potential Adverse Effect ◽

Severe Neutropenia ◽

First Episode ◽

Antipsychotic Medications ◽

Increased Risk ◽

Episode Psychosis

Abstract Background Neutropenia, a decrease in total number of neutrophils below 1500/mm3 and particularly severe neutropenia, defined as neutrophils less than 500/mm3, is a potential adverse effect of antipsychotic medications that can lead to increased risk of infections and death. However, much of the attention on the potential adverse effect is centered exclusively on clozapine, which remains the only antipsychotic medication in the United States requiring standardized monitoring of blood work. We demonstrate here that paliperidone can also cause neutropenia and therefore clinicians should be aware of this possibility especially during initiation of treatment. Case presentation The following report presents the case of a 23-year-old African American male with first episode psychosis who developed neutropenia after initiation of paliperidone. Neutropenia resolved after discontinuation of paliperidone and initiation of an alternative antipsychotic, haloperidol. Conclusions This case report demonstrates an example of paliperidone induced neutropenia which resolved with a switch to haloperidol. We conclude that when initiating paliperidone, clinicians should be more aware of the risk of neutropenia. Moreover, neutropenia may be a more common and overlooked issue in patients on antipsychotic medications other than clozapine and increased awareness of comparative risk across antipsychotics could help direct treatment.

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Vestibular neuritis caused by severe acute respiratory syndrome coronavirus 2 infection diagnosed by serology: Case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x211013261 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110132

Author(s):

Alexandra Halalau ◽

Madalina Halalau ◽

Christopher Carpenter ◽

Amr E Abbas ◽

Matthew Sims

Keyword(s):

Case Report ◽

Severe Acute Respiratory Syndrome ◽

Medical History ◽

Cranial Nerve ◽

Respiratory Illness ◽

Vestibular Neuritis ◽

Past Medical History ◽

Significant Past Medical History ◽

Eighth Cranial Nerve ◽

Male Physician

Vestibular neuritis is a disorder selectively affecting the vestibular portion of the eighth cranial nerve generally considered to be inflammatory in nature. There have been no reports of severe acute respiratory syndrome coronavirus 2 causing vestibular neuritis. We present the case of a 42-year-old Caucasian male physician, providing care to COVID-19 patients, with no significant past medical history, who developed acute vestibular neuritis, 2 weeks following a mild respiratory illness, later diagnosed as COVID-19. Physicians should keep severe acute respiratory syndrome coronavirus 2 high on the list as a possible etiology when suspecting vestibular neuritis, given the extent and implications of the current pandemic and the high contagiousness potential.

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561 Bilateral Upper Extremity Amputation After High Voltage Electrical Injury: A Case Report

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.211 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S130-S131

Author(s):

Andrew Khalifa ◽

Anzar Sarfraz ◽

Jacob B Avraham ◽

Ronnie Archie ◽

Matthew Kaminsky ◽

...

Keyword(s):

Case Report ◽

High Voltage ◽

Troponin I ◽

Low Voltage ◽

Foley Catheter ◽

The United States ◽

Upper Extremities ◽

Full Thickness ◽

Electrical Injuries

Abstract Introduction Electrical injuries represent 0.4–3.2% of admissions to burn units and are responsible for >500 deaths per year in the United States. Approximately half occur in the workplace and are the fourth leading cause of work-related-traumatic death. The extent of injury can be drastically underestimated by total body surface area percentage (TBSA). Along with cutaneous burns, high voltage electrical injuries can lead to necrosis of muscle, bone, nervous tissue, and blood vessels. Aggressive management allows for patient survival, but at significant cost. Newer technologic advances help improve functional outcomes. Methods This case-report was conducted via retrospective chart review of the case presented. Results A 43-year-old male sustained a HVEI (>10, 000 V) after contacting an active wire while working as a linesman for an electric company. He presented after less than 15-minute transport from an outside hospital with full thickness burns and auto-amputation to all fingers on both hands and the distal third of the left hand (Images 1 and 2). There were full thickness circumferential burns to the entire left and right upper extremities with contractures, with the burns extending into the axilla, and chest wall musculature. The patient had 4th degree burns and a large wound to the left shoulder with posterior extension to the scapula, flank and back with approximately 25% TBSA (Image 3). Compartments were tense in both upper extremities. Patient was sedated and intubated to protect the airway and placed on mechanical ventilation. A femoral central line was then placed, and the patient was given pain control, continued fluid resuscitation, and blood products. Dark red colored urine from a foley catheter that was immediately identified as rhabdomyolysis induced myoglobinuria. Labs drawn demonstrated elevated troponin I, CK >40,000. BUN 18, creatinine 1.0, K+ 5.2 and phosphate 5.6. Decision was made immediately for operative intervention with emergent amputation of both upper extremities in the light of rhabdomyolysis secondary to tissue necrosis and oliguria. During the patient’s hospital course, he underwent multiple operations for further debridement with vacuum-assisted closure therapy and skin grafting of sites, as well as targeted muscle reinnervation (TMR) 6 months later at an outside hospital. Conclusions Although HVEI only account for a small percentage of burn admissions, they are associated with greater morbidity than low-voltage injuries. Patients with HVEI often incur multiple injuries, more surgical procedures, have higher rates of complications, and more long term psychological and rehabilitative difficulties. Despite the need for amputation in some of these critically ill patients, options exist that allow for them to obtain long term functional success.

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