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Antifreeze on a freezing morning: ethylene glycol poisoning in a 2-year-old

Gayle Hann1, Dana Duncan, Gopakumar Sudhir

  • 1Paediatrics Department, North Middlesex Hospital, London, UK. gaylehann@yahoo.com

BMJ Case Reports
|May 19, 2012
PubMed

Insights

A 2-year-old child survived a life-threatening ethylene glycol (EG) poisoning without intensive care. Successful management in a high dependency unit highlights effective multi-disciplinary care and fomepizole use.

Area of Science:

  • Pediatric Toxicology
  • Emergency Medicine
  • Pharmacology

Background:

  • Ethylene glycol (EG) poisoning is rare but potentially fatal in children.
  • Fomepizole is an effective antidote for EG poisoning, but its use in pediatric cases is infrequently reported.
  • Management typically requires a pediatric intensive care unit (PICU).

Observation:

  • A 2-year-old child presented with symptoms of EG poisoning, including irritability, pallor, confusion, and high anion gap metabolic acidosis.
  • No PICU beds were available in the region for this patient.
  • The child was managed in a high dependency unit.

Findings:

  • Successful treatment of severe ethylene glycol poisoning in a child outside of a PICU.
  • The patient received fomepizole and multidisciplinary team care.
  • Full recovery and discharge within 7 days.

Implications:

  • This case demonstrates that fomepizole and multidisciplinary team management can lead to positive outcomes in pediatric EG poisoning even without PICU admission.
  • Highlights the importance of resourcefulness and adaptability in managing critical pediatric cases.
  • Suggests potential for successful management in high dependency units, broadening treatment accessibility.

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