American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2015, 3(9), 276-277
DOI: 10.12691/ajmcr-3-9-3
Open AccessCase Report

Where is the Gap Coming from?

Myriam C Vela-Ortiz1, , Yanfang Guan1, Sukhminder Singh1, Vinay Rupashree2 and Richard Snyder2

1Medical Resident, Internal Medicine Residency, Easton Hospital, Department of Medicine

2Internal Medicine Residency, Easton Hospital, Department of Medicine

Pub. Date: July 26, 2015

Cite this paper:
Myriam C Vela-Ortiz, Yanfang Guan, Sukhminder Singh, Vinay Rupashree and Richard Snyder. Where is the Gap Coming from?. American Journal of Medical Case Reports. 2015; 3(9):276-277. doi: 10.12691/ajmcr-3-9-3

Abstract

A 52 year old male with history of alcohol abuse presented to the hospital with metabolic acidosis, he reported consuming a bottle of Listerine for the past two months. On admission he high anion gap and osmolar gap. Given the severe acidosis the patient was started on a bicarbonate drip and also Fomepizole. Later the assays for ethylene glycol and methanol came back negative. Clinicians should have a high index of suspicion for Listerine use and other over the counter products in patients with a history of ethanol abuse, especially when they present with high anion gap and osmolar gap.

Keywords:
anion gap acidosis fomepizole intoxication listerine osmolar gap

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References:

[1]  Lachenmeier, D.W., et al., What happens if people start drinking mouthwash as surrogate alcohol? A quantitative risk assessment. Food Chem Toxicol, 2013. 51: p. 173-8.
 
[2]  Westermeyer, R.R. and R.N. Terpolilli, Cardiac asystole after mouthwash ingestion: a case report and review of the contents. Mil Med, 2001. 166(9): p. 833-5.
 
[3]  Farley, P.C., K.Y. Lau, and S. Suba, Severe hypernatremia in a patient with psychiatric illness. Arch Intern Med, 1986. 146(6): p. 1214-5.
 
[4]  Minocha, A., et al., Effect of activated charcoal in 70% sorbitol in healthy individuals. J Toxicol Clin Toxicol, 1984. 22(6): p. 529-36.
 
[5]  Dirk W. Lachenmeier , Y.B.M., Mariya Markova , Thomas Kuballa , Jürgen Rehm, What happens if people start drinking mouthwash as surrogate alcohol? A quantitative risk assessment. Food Chem Toxicol, 2013. 51: p. 173-178.
 
[6]  Chan, T.Y., Potential dangers from topical preparations containing methyl salicylate. Hum Exp Toxicol, 1996. 15(9): p. 747-50.
 
[7]  Egbert, A.M., et al., Alcoholics who drink mouthwash: the spectrum of nonbeverage alcohol use. J Stud Alcohol, 1985. 46(6): p. 473-81.
 
[8]  Sperry, K. and R. Pfalzgraf, Fatal ethanol intoxication from household products not intended for ingestion. J Forensic Sci, 1990. 35(5): p. 1138-42.