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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.

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Article

Where is the Gap Coming from?

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

2Internal Medicine Residency, Easton Hospital, Department of Medicine


American Journal of Medical Case Reports. 2015, Vol. 3 No. 9, 276-277
DOI: 10.12691/ajmcr-3-9-3
Copyright © 2015 Science and Education Publishing

Cite this paper:
Myriam C Vela-Ortiz, Yanfang Guan, Sukhminder Singh, Vinay Rupashree, 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.

Correspondence to: Myriam  C Vela-Ortiz, Medical Resident, Internal Medicine Residency, Easton Hospital, Department of Medicine. Email: cristiveo1986@gmail.com

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.

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