Acute tricresylphosphate intoxication in childhood

Tricresylphosphates (TCP) have been responsible for a large number of epidemic and individual intoxications since the recognition, in 1899, that phospho-creosote was the cause of paralysis in patients being treated for tuberculosis. Although children are mentioned as being among the victims of epidemic intoxication, no well documented reports of acute tricresylphosphate ingestion in childhood are available in the literature. We report a case of severe intoxication in a 4 1/2-year-old child following ingestion of a lubricant containing TCP. Clinical findings in this child were typical of previously reported acute ingestions in adults: acute gastro-intestinal symptoms, delayed cholinergic crisis and neurological toxicity. Previous literature is reviewed briefly and discussed.