Background: Butanol (butyl alcohol) is a chemical which occurs naturally in some foods and is used in the manufacture of other chemicals. Current data on butanol poisoning in humans are limited.
Objective: This study describes clinical characteristics and outcomes of patients exposed to products containing butanol.
Methods: We performed a 5-year retrospective cross-sectional study by analyzing data from the Ramathibodi Poison Center Toxic Exposure Surveillance System for 2013– 2017.
Results: There were 163 patients included in the study. All products containing butanol reported were agricultural adjuvant products. Most (67.5%) patients were males and had ingested butanol accidentally (75.5%). The median age was 42 years. Almost all patients had oral exposure to butanol. At presentation, most of our patients had normal vital signs and were conscious. Clinical presentations mostly included gastrointestinal symptoms (65%) and local irritation (28.8%). Fifty-four patients (33.1%) had no obvious clinical effects at presentation. Most patients had normal laboratory tests at presentation, although eight developed systemic effects including high anion gap metabolic acidosis (n=8), acute kidney injury (AKI; n=5), depression of consciousness (n=5), and hypotension (n=3). Of these eight patients, two with intentional ingestion developed altered consciousness, hypotension, AKI, severe metabolic acidosis, and eventually died. One of these died within 1 day after ingestion, while the other died later through complications during admission. Therefore, the mortality rate was 1.23%. Sixty-six patients (40.5%) were admitted to hospitals, with a median length of stay of 1 day. Most patients received only supportive treatment and fully recovered.
Conclusion: Agricultural adjuvant products containing butanol or butanol itself caused only mild effects in most patients, but systemic effects occurred in some. The mortality from this poisoning was very low, and both fatalities were from intentional ingestion. Supportive care and proper management of complications should be the main treatment for this form of poisoning.



中文翻译：

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含丁醇产品的中毒：临床特征和结果

背景：丁醇（丁醇）是一种天然存在于某些食品中的化学物质，用于制造其他化学物质。目前关于人类丁醇中毒的数据有限。
目的：本研究描述了暴露于含丁醇产品的患者的临床特征和结果。
方法：我们通过分析来自拉马蒂博迪毒物中心毒物暴露监测系统 2013-2017 年的数据，进行了一项为期 5 年的回顾性横断面研究。
结果：该研究包括163名患者。报告的所有含有丁醇的产品都是农用助剂产品。大多数 (67.5%) 患者是男性并且意外摄入了丁醇 (75.5%)。中位年龄为 42 岁。几乎所有患者都口服过丁醇。就诊时，我们的大多数患者生命体征正常且意识清醒。临床表现主要包括胃肠道症状（65%）和局部刺激（28.8%）。54 名患者 (33.1%) 在就诊时没有明显的临床效果。大多数患者在就诊时实验室检查正常，但有 8 名患者出现全身反应，包括高阴离子间隙代谢性酸中毒 (n=8)、急性肾损伤 (AKI；n=5)、意识抑制 (n=5) 和低血压 (n =3)。这八名患者中，故意摄入的两名患者出现意识改变、低血压、AKI、严重的代谢性酸中毒，最终死亡。其中一人在摄入后 1 天内死亡，而另一人后来因入院并发症而死亡。因此，死亡率为1.23%。66 名患者 (40.5%) 入院，中位住院时间为 1 天。大多数患者只接受了支持治疗并完全康复。
结论：含有丁醇或丁醇本身的农用助剂产品对大多数患者仅造成轻微影响，但部分患者出现全身性影响。这种中毒的死亡率非常低，而且两次死亡都是故意摄入造成的。支持性护理和对并发症的适当管理应该是这种中毒形式的主要治疗方法。