title: A case of methanol intoxication caused by methomyl pesticide ingestion.
abstract: When clinicians treat patients with pesticide poisoning, they often pay attention only to the chief toxic agent and ignore the toxicity of the pesticide's additives or solvents. Occasionally, however, a solvent (e.g. methanol) may itself be the cause of poisoning. We report a case of acute methanol intoxication that occurred after ingestion of a methomyl pesticide that contained methanol as an additive. A 49-year-old man was brought to the emergency department in an unconscious state after ingestion of 20 ml of a carbamate pesticide (chief ingredient: methomyl; active ingredient: methanol). Upon arrival, he was semicomatose and did not breathe spontaneously; however, his cholinesterase level was within normal limits and cholinergic symptoms were not observed. High anion gap metabolic acidosis was present. His blood ethanol level was 74.8 mg/dL. The urine methanol level was 55.60 mg/dL, and urine ethanol level was 22.0 mg/dL. He was treated with hemodialysis; subsequently, his metabolic acidosis resolved and he returned to normal mental status. We guessed that methanol, as the solvent of the methomyl, had produced the symptoms. When treating pesticide-poisoned patients, clinicians should identify the solvent used in the pesticide, because solvents such as methanol may exacerbate the symptoms of poisoned patients.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Korea.
authors.forename: H W
authors.initials: HW
authors.lastname: Gil
authors.forename: J R
authors.initials: JR
authors.lastname: Hong
authors.forename: H Y
authors.initials: HY
authors.lastname: Song
authors.forename: S Y
authors.initials: SY
authors.lastname: Hong
mesh_terms: D000138:Acidosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000435:Alcoholic Intoxication / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004338:Drug Combinations; D006801:Humans; D007306:Insecticides / Q000633:toxicity*; D008297:Male; D000432:Methanol / Q000009:adverse effects*; D008724:Methomyl / Q000633:toxicity*; D008875:Middle Aged; D006435:Renal Dialysis; D012997:Solvents / Q000009:adverse effects*
chemical_list: D004338:Drug Combinations; D007306:Insecticides; D012997:Solvents; D008724:Methomyl; D000432:Methanol