Quinine poisoning in children

The accidental ingestion of quinine by children causes significant morbidity and mortality. We have reviewed quinine poisoning as presented in the medical literature and our experience of paediatric quinine poisoning during the period from January 1975 to September 1986. The clinical features that were seen in our patients were similar to those that are described in larger series. In our series, 13 children were identified, of whom 11 children were aged one to two years. Ten children either remained asymptomatic or made a complete recovery. Two children had a persisting major deficit and one died. Once ingestion of quinine has occurred, absorption should be prevented by the emptying of the stomach with ipecacuanha or gastric lavage promptly and then by the administration of activated charcoal. Once toxicity develops, supportive therapy should be given, but there is no specific therapy to reduce toxicity or to enhance elimination. Physicians who prescribe quinine should be aware of the potential dangers to small children.