Fortuitous detection of methanol poisoning in a drunken man.

We report a case of wood alcohol (methylated spirits) poisoning in a 40-yea r-old chronic alcoholic. The initial diagnosis of state of drunkenness was supported by the increased plasma level of ethanol (4.66 g.L-1) obtained wi th enzymatic method. The confirmation, using gas chromatography (GC), showe d an unexpected peak with a retention time at 1.19 min, characteristic of m ethanol (0.41 g.L-1). The GC analysis of the absorbed beverage revealed a 5 % methanol content. The osmolal gap was 115 mOsm.kg(-1), with 13 mOsm.kg(-1 ) due to methanol and 90 mOsm.kg(-1) to ethanol. Seven hours after the inge stion, the anion gap was at 13 mmol(-1). This result reflected the inhibiti on of methanol oxidation by alcohol-deshydrogenase, when the plasma ethanol concentration was above 1 g.L-1. This concentration was maintained by cont inuous intravenous administration of (Curethyl-A(R)) a 95% ethanol containi ng solution, until methanol concentration decreased below 0.2 g.L-1. The ou tcome was favourable without neurological and ophtalmological sequelae, (C) 2000 Editions scientifiques et medicales Elsevier SAS.