Intravenous fluorescein overdose in a child undergoing fluorescein angiography

Area of Science:

• Ophthalmology
• Toxicology
• Pediatrics

Background:

• Fluorescein angiography is a key imaging technique for pediatric retinal vascular conditions.
• Fluorescein dye has a generally safe profile at recommended intravenous doses.
• Limited data exists on intravenous supratherapeutic fluorescein exposure effects.

Observation:

• A 10-month-old infant with incontinentia pigmenti received over four times the standard fluorescein dose.
• The child exhibited significant yellow discoloration of skin, sclera, stool, and urine post-procedure.

Findings:

• The supratherapeutic fluorescein dose led to transient, visible external and internal yellowing.
• Toxicology assessment and 8-hour monitoring revealed no adverse sequelae.
• The patient experienced no long-term complications following the overdose.

Implications:

• This case provides novel insight into the effects of intravenous fluorescein overdose in a pediatric patient.
• It supports the generally reassuring safety profile of fluorescein dye even at supratherapeutic levels.
• Highlights the importance of vigilant monitoring after potential medication errors in pediatric procedures.