An unusual case of homicide by chronic methanol poisoning

An unusual case of homicide by chronic methanol poisoning is presented. A 37-year-old man with a month-long illness of intermittent nausea, vomiting, and shortness of breath presented in the emergency department with severe gastrointestinal pain, diaphoresis, tachycardia, metabolic acidosis, and tachypnea with labored breathing. Stat toxicology testing disclosed a serum methanol level of 750 mg/l. Despite appropriate medical treatment the patient developed multi-organ failure and died. The investigation revealed that bottles of a sport drink ingested regularly by the victim and prepared by a family member were the source of the methanol. The family member was convicted of murder. The use of methanol as an agent for murder is extremely rare.