title: A 44-year-old woman with metabolic acidosis, high anion gap, and delayed neurologic deterioration.
abstract: A 44-year-old woman was brought to the ED from John F. Kennedy International Airport. The patient was returning with her son from a 3-month visit to Bangladesh. Her journey started with a 4-h flight from Dhaka, Bangladesh to Dubai, United Arab Emirates. She consumed 240 mL of whiskey during the flight. This was followed by a 14-h flight from Dubai to New York. According to the patient's son, she did not consume any alcohol during the second flight. The patient was in her usual state of health with normal mentation throughout her journey. Upon landing, she started complaining of shortness of breath. After disembarking, she was witnessed to have seizure-like activity with involuntary passage of urine, following which she collapsed. The patient was intubated by emergency medical services in the field.
authors.affiliation: Department of Pulmonary Medicine, Jamaica Hospital Medical Center, Queens, NY. Electronic address: apvakil@gmail.com.
authors.forename: Abhay
authors.initials: A
authors.lastname: Vakil
authors.affiliation: Department of Internal Medicine, Jamaica Hospital Medical Center, Queens, NY.
authors.forename: Hinesh
authors.initials: H
authors.lastname: Upadhyay
authors.affiliation: Department of Pulmonary Medicine, Jamaica Hospital Medical Center, Queens, NY.
authors.forename: Khalid
authors.initials: K
authors.lastname: Sherani
authors.affiliation: Department of Clinical Research, Jamaica Hospital Medical Center, Queens, NY.
authors.forename: Kelly
authors.initials: K
authors.lastname: Cervellione
authors.affiliation: Department of Radiology, Jamaica Hospital Medical Center, Queens, NY.
authors.forename: Scott
authors.initials: S
authors.lastname: Trepeta
authors.affiliation: Department of Pulmonary Medicine, Jamaica Hospital Medical Center, Queens, NY.
authors.forename: Mahendra C
authors.initials: MC
authors.lastname: Patel
mesh_terms: D000136:Acid-Base Equilibrium; D000138:Acidosis / Q000139:chemically induced / Q000175:diagnosis*; D000328:Adult; D001927:Brain Diseases / Q000139:chemically induced / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D000432:Methanol / Q000506:poisoning*; D009336:Necrosis / Q000139:chemically induced / Q000175:diagnosis; D011699:Putamen / Q000187:drug effects / Q000473:pathology*; D012997:Solvents / Q000506:poisoning; D014057:Tomography, X-Ray Computed
chemical_list: D012997:Solvents; D000432:Methanol