{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T07:58:14Z","timestamp":1768463894478,"version":"3.49.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T00:00:00Z","timestamp":1603152000000},"content-version":"vor","delay-in-days":293,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Alcohol-containing hand sanitizers are part of the strategy to prevent person-to-person transmission during the COVID-19 pandemic. The purpose of this report was to present a case of ethanol-induced hand sanitizer intoxication after spine surgery in a patient with a postoperative delirious state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case<\/jats:title>\n                    <jats:p>A 63-year-old man was admitted to the spine department with intractable back pain as the main symptom and diagnosed with infectious spondylitis with discitis. The patient suddenly showed mental changes, resulting in a semi-comatose mental state the first day after surgery, without seizure-like activity and asphyxia. We subsequently discovered the patient had consumed half of an ethanol hand sanitizer bottle (about 300\u2013400 mL) which was placed at the foot of the bed to prevent infection transmission during the COVID-19 pandemic. The patient did not tend to depend on alcohol or psychiatric medication in the past, and had no addiction. After seven months, the patient had complete bone union and independent ambulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Acute ethanol intoxication can result in life-threatening clinical effects. One of the major problems after orthopedic surgery is delirium, with the largest number appearing after spine surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hand sanitizer, mainly composed of ethanol, did not cause abnormal findings or interfere with the course of treatment of infectious spondylitis. However, it is expected that such accidents will increase, due to the increase in the use of hand sanitizers caused by COVID-19. It is, therefore, necessary to avoid potential patient abuse, especially after spinal surgery in patients at risk of delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2020.10.086","type":"journal-article","created":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T13:14:04Z","timestamp":1603804444000},"page":"76-79","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Intoxication by hand sanitizer due to delirium after infectious spondylitis surgery during the COVID-19 pandemic"],"prefix":"10.1097","volume":"77","author":[{"given":"Dong-Ju","family":"Lim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-19-20260114","doi-asserted-by":"crossref","first-page":"351","DOI":"10.2147\/CIA.S2759","article-title":"Postoperative delirium in the elderly: diagnosis and management","volume":"3","author":"Robinson","year":"2008","journal-title":"Clin. Interv. Aging"},{"key":"R2-19-20260114","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1001\/jama.1990.03440080075027","article-title":"A prospective study of delirium in hospitalized elderly","volume":"263","author":"Francis","year":"1990","journal-title":"JAMA"},{"key":"R4-19-20260114","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1056\/NEJMc063110","article-title":"Intoxication of a prison inmate with an ethyl alcohol\u2013based hand sanitizer","volume":"356","author":"Doyon","year":"2007","journal-title":"N Eng. J. Med"},{"key":"R5-19-20260114","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.ejim.2007.06.033","article-title":"Acute alcohol intoxication","volume":"19","author":"Vonghia","year":"2008","journal-title":"Eur. J. Intern. Med"},{"key":"R6-19-20260114","doi-asserted-by":"crossref","first-page":"486","DOI":"10.7861\/clinmedicine.15-5-486","article-title":"Acute alcohol toxicity and withdrawal in the emergency room and medical admissions unit","volume":"15","author":"Morgan","year":"2015","journal-title":"Clin. Med"},{"key":"R7-19-20260114","doi-asserted-by":"crossref","first-page":"470","DOI":"10.3109\/15563650.2014.914527","article-title":"Isopropanol poisoning","volume":"52","author":"Slaughter","year":"2014","journal-title":"Clin. Toxicol"},{"key":"R8-19-20260114","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1016\/j.jemermed.2013.03.018","article-title":"Death caused by ingestion of an ethanol-based hand sanitizer","volume":"45","author":"Schneir","year":"2013","journal-title":"J. Emerg. Med"},{"key":"R9-19-20260114","first-page":"106","article-title":"Severe ethanol poisoning: a case report and brief review","volume":"5","author":"Sanap","year":"2003","journal-title":"Crit. Care Resusc"},{"key":"R10-19-20260114","doi-asserted-by":"crossref","first-page":"101","DOI":"10.3389\/fneur.2012.00101","article-title":"Delirium in elderly people: a review","volume":"3","author":"Martins","year":"2012","journal-title":"Front. Neurol"},{"key":"R11-19-20260114","doi-asserted-by":"crossref","first-page":"90","DOI":"10.5312\/wjo.v11.i2.90","article-title":"Postoperative delirium after major orthopedic surgery","volume":"11","author":"Urban","year":"2020","journal-title":"World J. Orthop"},{"key":"R12-19-20260114","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.spinee.2005.06.010","article-title":"Postoperative delirium in spine surgery","volume":"6","author":"Kawaguchi","year":"2006","journal-title":"Spine J"},{"key":"R13-19-20260114","first-page":"1","article-title":"Incidence and risk factors for postoperative delirium in patients undergoing spine surgery: a systematic review and meta-analysis","volume":"2019","author":"Wu","year":"2019","journal-title":"Biomed Res. Int"},{"key":"R14-19-20260114","doi-asserted-by":"crossref","first-page":"700","DOI":"10.21037\/qims.2019.04.09","article-title":"The risk factors associated with delirium after lumbar spine surgery in elderly patients","volume":"9","author":"Pan","year":"2019","journal-title":"Quant. Imaging Med. Surg"},{"key":"R15-19-20260114","doi-asserted-by":"crossref","first-page":"403","DOI":"10.21037\/jss.2017.08.12","article-title":"Impact of alcohol use on 30-day complication and readmission rates after elective spinal fusion (\u22652 levels) for adult spine deformity: a single institutional study of 1,010 patients","volume":"3","author":"Elsamadicy","year":"2017","journal-title":"J. Spine Surg"},{"key":"R16-19-20260114","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/j.otsr.2015.08.001","article-title":"Is hospital information system relevant to detect surgical site infection? Findings from a prospective surveillance study in posterior instrumented spinal surgery","volume":"101","author":"Boetto","year":"2015","journal-title":"Orthop. Traumatol. Surg. Res"},{"key":"R17-19-20260114","doi-asserted-by":"crossref","first-page":"1460","DOI":"10.1097\/01.brs.0000166532.58227.4f","article-title":"Risk factors for infection after spinal surgery","volume":"30","author":"Fang","year":"2005","journal-title":"Spine"},{"key":"R18-19-20260114","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1089\/sur.2015.009","article-title":"Alcohol consumption increases post-operative infection but not mortality: a systematic review and meta-analysis","volume":"16","author":"Shabanzadeh","year":"2015","journal-title":"Surg. Infect"},{"key":"R19-19-20260114","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jor.2018.12.011","article-title":"Alcoholism as a predictor for pseudarthrosis in primary spine fusion: an analysis of risk factors and 30-day outcomes for 52,402 patients from 2005 to 2013","volume":"16","author":"Passias","year":"2019","journal-title":"J. Orthop"},{"key":"R20-19-20260114","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1111\/j.1530-0277.2012.01830.x","article-title":"Acute alcohol exposure impairs fracture healing and deregulates \u03b2-catenin signaling in the fracture callus","volume":"36","author":"Lauing","year":"2012","journal-title":"Alcohol. Clin. Exp. Res"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220309640?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261220309640?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.10.086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T13:09:10Z","timestamp":1768396150000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2020.10.086"}},"subtitle":["A case report and literature review"],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":19,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2020.10.086","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}