Severe metabolic acidosis after transformer oil ingestion #F
The present case has been reported in the Journal of Medical Case Reports. This case presented with a major diagnostic as well as treatment challenge because the authors encountered such a case for the first time and were totally unaware of the fact that methanol might make up the main component of an aged transformer oil.

A 19-year-old man was brought to the hospital with altered sensorium. He was found to have elevated anion gap acidosis, increased osmolal gap, and acute kidney injury. He had no evidence of rhabdomyolysis or hemolysis. Computed tomography of his head showed cerebral edema. He was resuscitated with intravenous fluids and bicarbonate.

Three days later, he confessed taking transformer oil with suicidal intention. His clinical picture mimicked acute methanol intoxication. With an initial improvement in his neurological status, he started complaining of constant headache with episodes of agitation and delirium.

His renal function continued worsening despite an adequate urine output. He showed a remarkable improvement in his neurological state after just one session of hemodialysis.

Major takeway:-
- There is evidence that aged transformer oil contains methanol, and a patient who consumes it can present with features mimicking acute methanol intoxication.

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