Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports

  • Micah Heldeweg Department of Intensive Care, Amsterdam University Medical Centers, location VUmc, Amsterdam, the Netherlands
  • Louisa Kluijver Department of Internal Medicine, Alrijne Hospital, Leiden, the Netherlands
  • Kenrick Berend Department of Internal Medicine, Curaçao Medical Center, Curaçao


Toxic alcohols, anion gap, osmolal gap, doctor delay


Toxic alcohol poisoning can be lethal if not identified early and treated appropriately. Toxic alcohol assays are often unavailable in low-resource setting, so clinicians have to infer a diagnosis based on suspicion, repeated evaluation and biochemical course. We report a case of toxic alcohol poisoning concealed by auto-intoxication with in-hospital hand sanitizer. The eventual appearance of a concurrent high anion gap prompted dialysis. In another case, a comatose patient presented with a high osmolal gap and a high anion gap. Incorrect a priori opinions caused us to defer dialysis and the patient died shortly afterwards. Clinicians should be aware that toxic alcohol poisoning can produce a confusing diagnostic picture with an insidious course, and that doctor delay can prove fatal.



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  • Published: 2021-08-03

    Issue: 2021: Vol 8 No 8 (view)

    Section: Articles

    How to cite:
    Heldeweg M, Kluijver L, Berend K. Intoxication by Hand-Sanitizers and other Toxic Alcohols in a Low-Resource Setting: Two Case Reports. EJCRIM 2021;8 doi:10.12890/2021_002751.

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