Using alcohol to rinse mouth, man falls into coma

The Poison Control Center, Bach Mai Hospital recently admitted a 55-year-old man (residing in Hoang Mai, Hanoi ) in a coma, respiratory failure, and severe metabolic acidosis. Test results showed that the patient's blood contained a high concentration of industrial methanol at 116.63 mg/dL, and brain MRI showed necrotic lesions and cerebral hemorrhage complications. It is worth noting that the patient had no history of alcoholism, was in good health, and had a habit of using alcohol to rinse his mouth and gargle to treat toothaches.

The patient’s family said that about a week ago, the patient had pulpitis. He bought 70-degree alcohol from a pharmacy near his house to gargle and hold in his mouth. The patient held it in his mouth continuously for 1 hour, 3-4 times a day.

Three days before being admitted to the hospital, the patient had a poor appetite, headache, dizziness, nausea, vomiting, fatigue, and then blurred vision. The patient was taken to the emergency room at the Neurology Center, Bach Mai Hospital.

At the time of initial hospitalization, in addition to the above symptoms, the patient was conscious, vital signs, normal heart and lungs, no sensory disturbances. MRI images of the brain showed a small infarction in the left pontine nucleus. Blood gas tests showed abnormalities. Subsequently, the patient gradually lost consciousness, dilated pupils, respiratory failure, coma, and had to be intubated and put on a ventilator. Suspected methanol poisoning, the patient was transferred to the Poison Control Center on the same day for assessment, treatment, and blood filtration.

Doctors at the Poison Control Center said the patient was poisoned by methanol. The test results of the alcohol sample the patient used showed that although the label said “70-degree ethanol”, there was no ethanol, but industrial methanol accounted for 77.5%. The patient used the “alcohol” to hold for a long time, had an open wound in his mouth (tooth pulp inflammation), the “alcohol” penetrated the mucosa and it is not excluded that the patient swallowed it during the holding process. These are the reasons that caused the patient to be poisoned and led to the critical condition as it is now.

According to Dr. Nguyen Trung Nguyen, Director of the Poison Control Center, Bach Mai Hospital, the common type of alcohol used for disinfection is ethanol, while methanol is industrial alcohol, a toxic chemical, has very poor disinfecting ability and should not be used for disinfection. Industrial alcohol methanol can be easily absorbed through the digestive tract, skin and respiratory tract. Methanol is also easily evaporated, so inhaling a lot or for a long time can also cause poisoning.

Alcohol used by patients to gargle (Photo: Nguyen Ha)

Through the above case, Dr. Nguyen Trung Nguyen recommends that people, when they need to buy alcohol, should buy it at reputable pharmacies, carefully read all the information on the alcohol bottle label, if it is antiseptic alcohol, there must be clear items. The "Ingredients" section must clearly state the concentration, ratio, and content of antiseptic alcohols such as ethanol and isopropanol, and must not contain methanol. The "Uses" section clearly states that it is used for sterilization or disinfection, sterilization, or disinfection. When there are ambiguous words such as "support sterilization/antiseptic/disinfectant/antiseptic" or only "sterilization/disinfection of instruments" without mentioning use on humans, you need to be very careful because they may be unsafe products.

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