Although organ donation after methanol intoxication was considered a serious

option [21], family authorization, necessary because there was no donor declaration or written will available, could unfortunately not be obtained. Ventilation- en vaso-active support was actively withdrawn thereafter. The 81-year-old shopkeeper and reseller of the “alcohol” was, 8 months later charged and found guilty of involuntary manslaughter, because he had been unaware of the fact that he had been selling a potentially lethal alcohol like methanol. Taking into account his age, health status, the loss of his shop and the fact that he felt guilty, he was sentenced to a suspended term in jail and Inhibitors,research,lifescience,medical to community service in an old men’s home for several weeks. Inhibitors,research,lifescience,medical Conclusions In the differential diagnosis of an emergency medicine accident, cultural background and behavior should always be taken into account. Methanol intoxication induced derangements of homeostasis are successfully treated with CVVH-DF and intravenous ethanol even in a hemodynamic instable patient. Methanol is safely and effectively cleared with CVVH-DF Metabolic improvements do not equal to healing the patient Signs of brain damage in methanol intoxication are not always based on necrosis and bleeding, but may also reflect severe brain edema. Do not sell what you don’t’ know yourself. List Inhibitors,research,lifescience,medical of abbreviations GCS: Glascow Coma Score; CVVH-DF: Continuous

VenoVenous Haemo-DiaFiltration; ADH: Alcohol Dehydrogenase; FDH: Formaldehyde Dehydrogenase. Inhibitors,research,lifescience,medical Consent In this case the patient was unable to give consent and no family or proxy was available

to give consent for publication. Since in this case only retrospective data of an already deceased patient were used, who was treated according standards of normal care, no informed consent or ethical approval was necessary for publication Inhibitors,research,lifescience,medical according to Dutch law. To make sure that no ethical or legal rules were violated we additionally asked the Medical Ethics Committee of the Erasmus MC as an independent surrogate proxy for the patient. After a few adjustments in the text to secure privacy, the consent for publication was granted. A copy of this proxy consent is available for review by the Editor-in-Chief of this Journal. Competing interests The authors declare that they have no competing interests. Authors’ contributions JLE treated the patient and wrote the case report, JB supervised the writing nearly and made some major changes in MS275 manuscript after reviewing the first versions. Both authors read and approved the final manuscript. Pre-publication history The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-227X/10/3/prepub
Congestive heart failure (CHF) is one of the leading causes of frequent visits to the emergency department (ED) with a prevalence of 1-2% in the general population and a five year mortality rate after diagnosis reported at 60% in males and 45% in females [1].