Fatale intoxicatie met het handdesinfectans Sterillium

A 71 year old hospitalized alcoholic was discovered comatose during rounds. On examination he was haemodynamically instable with nonfocal neurologic symptoms and unresponsive pinpoint pupils. The results of routine laboratory tests were normal, except an elevated serum ethanol concentration (1.8‰). Patient recovered from this episode. However, several days later a similar event occurred. Unfortunately, this time the patient did not survive. Toxicological screening of serum samples collected earlier, revealed a toxic 2-propanol level of 1600 mg/l, an acetone level of 55 mg/l and a 1-propanol level of 850 mg/l, which confirmed an earlier presumed accidental intoxication with the hand disinfectant Sterillium. The main constituent of Sterillium is 2-propanol, one of its actions on ingestion being depression of the central nervous system. Post-ingestion an increased osmol gap and a slight metabolic acidosis may be measured in serum. Treatment of a Sterillium intoxication includes prevention of absorption, enhanced elimination using haemodialysis and support of vital functions as necessary.