We present two cases of adult inhalational and percutaneous methanol t
oxicity resulting from transient exposure to vaporized methanol. Both
patients complained only of a mild headache at the time of the emergen
cy department evaluation and had normal physical examinations, normal
anion gaps, and peak methanol levels of 23 and 16 mg/dL, respectively.
Emergency physicians should recognize the potential for toxic transcu
taneous absorption of methanol. Because of the varying relationship be
tween clinical symptoms, physical examination findings, and anion gap
values to potentially toxic methanol exposures, acquisition of empiric
serum methanol levels appears warranted in appropriate situations.