Unwell after drinking homemade alcohol – A case of ethylene glycol poisoning

Abstract

Introduction: Delayed treatment of ethylene glycol poisoning can have catastrophic consequences that may result in death. Case report: Three young men presented to the Emergency Centre (EC) with a main complaint of feeling unwell after consuming “homemade alcohol”. A fourth person had died at home an hour earlier. Blood analysis revealed a raised anion gap metabolic acidosis as well as a raised osmolar gap in all three patients. Discussion: The clinical presentation of ethylene glycol and methanol poisoning is non-specific and can be difficult to differentiate from ethanol intoxication. Homemade alcohol preparations are commonly adulterated with ethylene glycol and methanol to improve their taste and sting. Toxic alcohol analysis is not routinely carried out by most laboratory services in South Africa, and when carried out, results are only made available a few days later. A high index of suspicion coupled with early blood gas analysis and a need for prompt and effective treatment whilst awaiting toxicology analysis may limit the associated high morbidity and mortality.

Keywords

• Homemade alcohol
• Ethylene glycol poisoning
• Raised anion gap metabolic acidosis
• Raised osmolar gap
• High index of suspicion