This case report details the unfortunate demise of a 25-year-old male with chronic alcoholism who presented with a constellation of concerning symptoms.

Presenting Concerns:

• The patient arrived at the emergency department exhibiting a ten-hour history of:

  • Headache

  • Abdominal pain

  • Vomiting

  • Difficulty breathing

  • Multiple episodes of generalized tonic-clonic seizures (grand mal seizures)

  • Loss of consciousness

• Notably, there was no reported fever or head injury.

Medical History:

• Chronic alcoholic

• Non-smoker

Examination Findings:

• Critical condition (E1M3 V1)

• Rapid breathing (tachypnea)

• Cold and clammy skin

• Unpalpable peripheral pulses

• Unrecordable blood pressure

• Normal-sized pupils unresponsive to light

• No response to stimulation on both feet (bilateral planter response)

• Abnormal lung sounds (bilateral coarse crepitations)

Laboratory Findings:

• Arterial blood gas (ABG) analysis revealed severe metabolic acidosis with high anion gap.

• Blood tests indicated elevated lactate and normal blood sugar.

• Complete blood count showed mild leukocytosis.

• Kidney function tests were mildly abnormal.

• Liver function tests demonstrated significant liver injury.

• Urine analysis was unremarkable.

Imaging Studies:

• Chest X-ray showed fluid buildup in the lower parts of both lungs (bilateral infiltrates).

• Head CT scan revealed damage in both brain regions responsible for movement control (bilateral basal ganglia necrosis). This finding initially suggested alcoholic intoxication.

Twist in the Tale:

• Family members denied any recent alcohol consumption due to imposed restrictions.

• They revealed the patient's excessive intake of a homeopathic cough remedy over the past five days.

• Upon investigation, the homeopathic medicine was identified as Causticum Hah, containing a high concentration of alcohol (90% by volume).

• The patient likely consumed a toxic amount of alcohol through excessive use of this remedy.

Treatment and Outcome:

• The patient received supportive care for severe alcohol intoxication, including intravenous fluids, thiamine, bicarbonate, and antibiotics.

• Unfortunately, due to financial constraints and facility limitations, blood ethanol levels were not measured.

• Despite aggressive management, the patient's condition continued to deteriorate, and he passed away on the third day of hospitalization.

Discussion:

This case highlights the potential dangers of misusing homeopathic remedies containing significant amounts of alcohol. Chronic alcoholics, particularly those with impaired judgment, are especially vulnerable to accidental alcohol poisoning through this route.

The report emphasizes the importance of:

• Detailed history taking, including any recent medication use, even seemingly innocuous remedies like homeopathy.