Where is the Gap Coming from?

Myriam C Vela-Ortiz^1, , Yanfang Guan¹, Sukhminder Singh¹, Vinay Rupashree² and Richard Snyder²

¹Medical Resident, Internal Medicine Residency, Easton Hospital, Department of Medicine

²Internal Medicine Residency, Easton Hospital, Department of Medicine

Cite this paper

Myriam C Vela-Ortiz, Yanfang Guan, Sukhminder Singh, Vinay Rupashree and Richard Snyder. Where is the Gap Coming from?. American Journal of Medical Case Reports. 2015; 3(9):276-277. doi: 10.12691/AJMCR-3-9-3

Abstract

A 52 year old male with history of alcohol abuse presented to the hospital with metabolic acidosis, he reported consuming a bottle of Listerine for the past two months. On admission he high anion gap and osmolar gap. Given the severe acidosis the patient was started on a bicarbonate drip and also Fomepizole. Later the assays for ethylene glycol and methanol came back negative. Clinicians should have a high index of suspicion for Listerine use and other over the counter products in patients with a history of ethanol abuse, especially when they present with high anion gap and osmolar gap.

Keywords

anion gap acidosis, fomepizole, intoxication, listerine, osmolar gap

Copyright

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