Abstract:
INTRODUCTION: Due to the nationwide lockdown to mitigate the spread of COVID-19 and subsequent alcohol ban in
South Africa, several cases of toxic alcohol ingestion presented to our emergency unit. Many of these patients
admitted to making home brews of alcohol while others simply use industrial toxic alcohols. The diagnosis of
these poisonings is challenging as direct assays are not available in our setting.
CASE REPORT: We present a case of presumed ethylene glycol poisoning that presented with persistent seizures and
a high anion gap metabolic acidosis (HAGMA).
DISCUSSION: A high index of suspicion for toxic alcohol poisoning should be maintained in patients presenting with
an altered mental status, seizures and a HAGMA. Indirect markers such as clinical features and laboratory results
can lead to the diagnosis when direct assays are unavailable.
