Methanol inhalation toxicity.
Significant toxicity can result from intentional methanol inhalation. We report seven cases, involving four patients, of intentional inhalation of CARB-MEDIC carburetor cleaner containing toluene (43.8%), methanol (23.2%), methylene chloride (20.5%), and propane (12.5%). Patients arrived at the emergency department with central nervous system depression, nausea, vomiting, shortness of breath, photophobia, and/or decreased visual acuity. Treatment included correction of acidosis, leucovorin and/or folic acid, ethanol infusions, and supportive care. Hemodialysis was necessary in three cases. Measured blood methanol levels ranged from 50.4 to 128.6 mg/dL. Blood formic acid levels were 120, 193, and 480 micrograms/mL, respectively, in three patients. Ophthalmic examinations revealed hyperemic discs and decreased visual acuity in one patient. One individual was found pulseless with several CARB-MEDIC cans nearby. Attempts at revival were unsuccessful. Clinicians should be aware that significant blood methanol and formic acid levels may occur after inhalation of methanol.
Frenia
M L
ML
Florida Poison Information Center/Clinical Toxicology Service, University Medical Center-Jacksonville.
Schauben
J L
JL
D000280:Administration, Inhalation; D000328:Adult; D000431:Ethanol / Q000627:therapeutic use; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D000432:Methanol / Q000506:poisoning*; D011041:Poisoning / Q000188:drug therapy; D019966:Substance-Related Disorders
D000431:Ethanol; D005492:Folic Acid; D002955:Leucovorin; D000432:Methanol