Detection of isopropyl alcohol in a patient with diabetic ketoacidosis.

A 29-year-old man presented to the Emergency Department with acute mental status changes. He was unable to give a history. He was found to be in diabetic ketoacidosis, although his family reported no prior history of diabetes. A toxic exposure work-up revealed the presence of isopropyl alcohol in the patient's blood. His condition improved with treatment of the ketoacidosis, and he subsequently denied any exposure to isopropyl alcohol prior to presentation to the hospital. This case provides further support to a growing body of evidence that the detection of isopropyl alcohol may not represent an acute ingestion but, rather, a byproduct of acetone metabolism in certain disease states.