{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:31:00Z","timestamp":1762432260483},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"9-10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,29]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Ethylene glycol (EG) toxicity is an important cause of toxic alcohol poisoning in the USA with over 5,000 exposures reported annually. While classically characterized by solitary accidental or intentional ingestions, mass toxic alcohol poisoning outbreaks and more rarely collective consumptions (typically of methanol) have been described. We describe an ethylene glycol poisoning from collective ingestion that involved soldiers presenting at William Beaumont Army Medical Center in El Paso, Texas. Eleven soldiers presented to the emergency department over a 12-h period after ingestion of an unknown substance. The first two patients exhibited severe neurologic symptoms, while the remainder were asymptomatic. As serum EG levels were not immediately available, treatment decisions were based on surrogate laboratory values. Two patients received immediate hemodialysis, and fomepizole (FOM) because of severe acidosis with elevated anion and osmolal gaps. These patients developed acute kidney injury with renal recovery within a 3-week period. Two patients with elevated lactate received bicarbonate-based intravenous (IV) fluids and FOM. Two patients received IV fluids only and required prolonged observation for worsening acidosis and\/or acute kidney injury. Five patients with normal laboratory values were treated with IV fluids and observation. All patients received cofactors including thiamine and pyridoxine. All patients survived. The outbreak occurred in the setting of limited dialysis resources, limited FOM availability, and in a resource-limited community. Additional guidelines are needed to determine allocation of limited resources, optimal dialysis and FOM treatment course, and comorbid conditions, which may prolong recovery.<\/jats:p>","DOI":"10.1093\/milmed\/usac380","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T07:36:38Z","timestamp":1671780998000},"page":"e3261-e3264","source":"Crossref","is-referenced-by-count":6,"title":["Mass Poisoning From Ethylene Glycol at a U.S. Military Base"],"prefix":"10.1093","volume":"188","author":[{"given":"Nina","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Medicine\u2014Nephrology, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurice","family":"Khayat","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Nephrology, Madigan Army Medical Center , Joint Base Lewis-McChord, WA 98431, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Owshalimpur","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Nephrology, Madigan Army Medical Center , Joint Base Lewis-McChord, WA 98431, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Banda","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Internal Medicine, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus","family":"Munoz","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Internal Medicine, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William C","family":"White","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Internal Medicine, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin M","family":"Forster","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Nephrology, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah K","family":"Petteys","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Pulmonary\/Critical Care Medicine, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott B","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Critical Care\/Emergency Medicine, William Beaumont Army Medical Center , El Paso, TX 79918, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maura","family":"Watson","sequence":"additional","affiliation":[{"name":"Department of Medicine\u2014Nephrology, Walter Reed National Military Medical Center , Bethesda, MD 20889, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua D","family":"King","sequence":"additional","affiliation":[{"name":"Department of Toxicology\u2014Maryland Poison Center and Department of Medicine\u2014Nephrology, University of Maryland , Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"issue":"12","key":"2023083018190363800_R1","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1080\/15563650.2021.1989785","article-title":"2020 Annual Report of the American Association of Poison Control Centers\u2019 National Poison Data System (NPDS): 38th annual report","volume":"59","author":"Gummin","year":"2021","journal-title":"Clin Toxicol"},{"issue":"2","key":"2023083018190363800_R2","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1093\/pubmed\/fdu038","article-title":"Methanol mass poisoning in Iran: role of case finding in outbreak management","volume":"37","author":"Hassanian-Moghaddam","year":"2015","journal-title":"J Pub Health"},{"key":"2023083018190363800_R3","article-title":"Methanol and ethylene glycol poisoning: management","author":"Sivilotti"},{"issue":"12","key":"2023083018190363800_R4","doi-asserted-by":"publisher","first-page":"1129","DOI":"10.1080\/15563650.2019.1636992","article-title":"Consensus statements on the approach to patients in a methanol poisoning outbreak","volume":"57","author":"Hassanian-Moghaddam","year":"2019","journal-title":"Clin Toxicol"},{"issue":"3","key":"2023083018190363800_R5","doi-asserted-by":"publisher","first-page":"54","DOI":"10.5492\/wjccm.v9.i3.54","article-title":"Lessons from a methanol poisoning outbreak in Egypt: six case reports","volume":"9","author":"Gouda","year":"2020","journal-title":"World J Crit Care Med"},{"issue":"3","key":"2023083018190363800_R6","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1056\/NEJMra1615295","article-title":"Toxic alcohols","volume":"378","author":"Kraut","year":"2018","journal-title":"N Engl J Med"},{"issue":"3","key":"2023083018190363800_R7","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1111\/bcp.12824","article-title":"Antidotes for poisoning by alcohols that form toxic metabolites","volume":"81","author":"McMartin","year":"2016","journal-title":"Br J Clin Pharmacol"},{"issue":"5","key":"2023083018190363800_R8","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1081\/CLT-100102445","article-title":"American Academy of Clinical Toxicology practice guidelines on the treatment of ethylene glycol poisoning. Ad Hoc Committee","volume":"37","author":"Barceloux","year":"1999","journal-title":"J Toxicol Clin Toxicol"},{"issue":"4","key":"2023083018190363800_R9","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1081\/CLT-120006745","article-title":"American Academy of Clinical Toxicology practice guidelines on the treatment of methanol poisoning","volume":"40","author":"Barceloux","year":"2002","journal-title":"J Toxicol Clin Toxicol"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/9-10\/e3261\/51307472\/usac380.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/188\/9-10\/e3261\/51307472\/usac380.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T18:19:08Z","timestamp":1693419548000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/188\/9-10\/e3261\/6958179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,23]]},"references-count":9,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2022,12,23]]},"published-print":{"date-parts":[[2023,8,29]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usac380","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,9,1]]},"published":{"date-parts":[[2022,12,23]]}}}