Windshield wiper fluid (Methanol) poisoning

Methanol is found in canned heating sources, antifreeze, windshield wiper fluid, fuel additives, and paint removers. Ingestion can be intentional or accidental. Methanol is converted into toxic metabolites that can cause blindness, confusion, and gastrointestinal symptoms. If left untreated it can be deadly.

Description

Methanol is found in canned heating sources, antifreeze, windshield wiper fluid, fuel additives, and paint removers. Ingestion can be intentional or accidental. Methanol is converted into toxic metabolites that can cause blindness, confusion, and gastrointestinal symptoms. If left untreated it can be deadly.

Symptoms

Vomiting, abdominal pain, blurry vision, blindness, confusion, lethargy, seizures, coma, low blood pressure, severe metabolic derangements, and death.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Blood tests to help make the diagnosis and check for electrolyte imbalances, and kidney and liver injury. An arterial blood gas will be done to measure the acid content in the blood.

Tests:
Pregnancy (BHCG) test, Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT angiogram of the neck, Electrocardiogram (EKG), Urinalysis (UA), X-ray

Other Specific Tests: Alcohol screen, serum osmolality

Specialists:
Medical Toxicology

Treatment

Ethanol or fomepizole (Antizol) is administered to prevent further metabolism of methanol. Severe intoxications will require dialysis. Supportive treatment including mechanical ventilation and intravenous fluids may be required.