Homicidal methanol poisoning in a child.

A case of homicidal poisoning of a 21-month-old child using methanol is presented. The child was found dead in his crib during a court-ordered visit to his father's home. He reportedly was experiencing "flu-like" symptoms the day before. Routine toxicology testing of specimens taken at autopsy revealed the presence of methanol in a concentration of 0.21%, 0.23%, 0.31%, 0.28%, and 0.26% (w/v or w/w) in heart blood, venous blood, urine, vitreous humor, and gastric contents, respectively. Formic acid concentrations were 1.0 and 6.4 g/L in heart blood and urine. No other drugs or chemicals were detected in comprehensive screening. Accidental ingestion of methanol was ruled out; however, the homicide investigation was complicated by the fact that up to seven adults at three different locations had been involved in the child's care. Minimal information in the literature on the time frame for the development of symptoms of methanol intoxication in a child of this age made predicting a likely time of ingestion difficult. Discussion of the investigation and the timeline for the poisoning that was eventually established are included.