Citation

Schoen JC, Cain MR, Robinson JA, Schiltz BM, Mannenbach MS. Pediatr. Emerg. Care 2016; 32(10): 688-690.

Affiliation

From the *Department of Emergency Medicine, †Department of Pediatric and Adolescent Medicine, ‡Division of Pediatric Critical Care Medicine, §Division of Pediatric Emergency Medicine; Mayo Clinic, Rochester, MN.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/PEC.0000000000000606

PMID

26785093

Abstract

We report the case of a 16-year-old healthy adolescent male who presented to the local emergency department with altered mental status. En route to a tertiary care facility, he began to decompensate and was found to be markedly acidotic. Further investigation revealed an elevated anion gap, and physical examination showed only abdominal pain and decreased level of consciousness. A broad differential diagnosis was considered at the time of the patient's presentation at the tertiary care center including ingestion of a volatile alcohol, sepsis, and an abdominal catastrophe. Although fomepizole and emergent dialysis were being initiated, laboratory tests confirmed ethylene glycol poisoning. This case demonstrates the importance of early recognition of potential ingestions in patients with altered mental status and supportive laboratory findings.

Language: en