title: Intoxication with mouthwash presenting as psychosis and delirium in a combat theater.
abstract: Alcohol is prohibited in combat zones, but it still can be obtained via covert sources. This can cause complex issues for the military physician. We present a case of a U.S. Marine in Iraq who was noted to have intermittent and unexplained behavioral changes. The patient had repeatedly denied alcohol use, but during a second medical evacuation from theater, a blood alcohol level was drawn. Results did not come back fast enough to prevent the evacuation, but did eventually confirm that he was intoxicated. Mouthwash was the source. This case illustrates the importance of screening for alcohol abuse and intoxication even in situations in which conventional use of alcohol is not anticipated.
authors.affiliation: Naval Medical Center San Diego, Department of Mental Health, 34800 Bob Wilson Dr., San Diego, CA 92134, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: McLay
authors.forename: Colleen
authors.initials: C
authors.lastname: McBrien
authors.forename: Brian
authors.initials: B
authors.lastname: Kleyensteuber
authors.forename: James
authors.initials: J
authors.lastname: Reeves
mesh_terms: D000328:Adult; D000435:Alcoholic Intoxication / Q000150:complications*; D000437:Alcoholism / Q000150:complications*; D003693:Delirium / Q000139:chemically induced*; D000431:Ethanol / Q000009:adverse effects* / Q000633:toxicity; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008403:Mass Screening; D008889:Military Personnel; D009067:Mouthwashes / Q000009:adverse effects* / Q000633:toxicity; D011604:Psychoses, Alcoholic / Q000209:etiology*; D014481:United States
chemical_list: D009067:Mouthwashes; D000431:Ethanol