Search

The demographics, sources and outcomes of methanol poisoning have not been described in Turkey. Our study identified the profile of acute methanol exposures reported to Drug and Poison Information Center (DPIC) in Izmir, Turkey, from 1993 to 2002. Data analysis included patient demographics, sources of methanol, reason for the exposure, clinical effects and outcomes of methanol poisoning. The DPIC recorded 30,485 calls concerning poisoning; 996 (3.3 %) alcohol poisonings were recorded and 113 (11.3 %) of them were methanol poisonings. There were 91 (80.5 %) males and 22 (19.5 %) females with a mean age of 34.7 +/- 1.3y (range 19-65) and 4.8 +/- 0.9y (range 1-18) in adults and children, respective. The sources of methanol were eu de cologne (72.6 %), spirits (10.6 %) and antifreeze (2.7 %). Accidental poisoning occurred in all children between 0 and 12y old, abuse (55.7 %) and intentional poisoning (27.3 %) were predominant in adults. Clinical signs in all cases were central nervous system symptoms (45.1 %), metabolic acidosis (23.0 %), visual symptoms (21.2 %) and gastrointestinal symptoms (10.6 %). Sixteen patients (14.1 %) died, 63 (55.8 %) had complete recovery and 1 (0.9 %) had irreversible visual problems. Most patients with methanol poisoning may die or present serious morbidity without appropriate treatment in a health care facility. Methanol for producing cheap "eu de colognes" in Turkey is the principal reason for severe poisoning and deaths. Public education about colognes and legislative control of cologne production are important in preventing methanol poisoning.

Dimethyl sulfoxide (DMSO) has been wide used in the treatment of arthritis and certain inflammatory diseases, and is also considered an alternative remedy for cancer even if not supported by concrete evidence. This report illustrates the first case of a fatal complication following the illicit use of this agent. A 55-y-old man who reportedly ingested 500 mg acetaminophen and similar to I ml DMSO solution was brought to the emergency department after experiencing 2 tonic-clonic seizures. He had been diagnosed with lung mesotelioma with brain metastases which caused no neurologic deficit. The ingested DMSO was the first dose within the last 3 mo. Examination revealed right-sided hemiplegia. Unenhanced computed tomography of the head showed 3 hemorrhagic areas with blood-cerebrospinal fluid at the left parietal, occipital and frontal regions accompanied by a midline shift. Despite initial resuscitation, 2 units of fresh frozen plasma and antiedema treatment, the patient experienced cardiac arrest that did not respond to resuscitative measures. DMSO can cause massive intrametastatic hemorrhage, and neurologic deterioration can be profound in patients with metastatic brain lesions.

We present a case with angioedema of the tongue, following 1 dose of an angiotensin-converting enzyme (ACE) inhibitor ingestion. A gradual progression of angioedema required tracheotomy despite aggressive medical treatment and illustrates the severity of this adverse reaction, Although ACE inhibitors are considered safe, emergency physicians should be alert for minor angioedema at presentation that may progress to life threatening airway compromise.

Latrodectism is considered dangerous for human beings. Acute renal failure after envenomation is not common and usually results from prerenal failure. We report a 59-y-o man with acute oliguric renal failure due to a combination of prerenal and renal causes after being bitten by a black Latrodectus spider. He had the characteristic anxiety, severe hypertension, tremor, facial edema, and generalized diaphoresis. The patient recovered within a week without sequelae. Clinicians should not overlook the possibility of acute renal failure in latrodectism.