[Poisoning by externally-administered ethanol in an infant]

Area of Science:

• Toxicology
• Pediatrics
• Neonatal Medicine

Background:

• Infants, especially neonates, have a higher risk of toxic absorption due to their immature skin barrier and higher surface area to volume ratio.
• The use of topical alcohol-based preparations in infants requires careful consideration due to potential systemic absorption.
• Unexplained neurological symptoms in neonates warrant a thorough differential diagnosis, including toxicological assessments.

Observation:

• A 15-day-old infant presented with unexplained coma.
• Investigation revealed significant ethanol poisoning with a blood alcohol level of 4.4 g/l.
• The infant had been treated with alcohol-containing dressings prior to the onset of symptoms.

Findings:

• Ethanol poisoning was confirmed as the cause of coma.
• Symptomatic treatment resulted in rapid improvement of the infant's condition within hours.
• The estimated half-life of ethanol in this infant was 17 hours.

Implications:

• This case underscores the critical danger of percutaneous absorption of ethanol through topical applications in young infants.
• It emphasizes the necessity of comprehensive toxicological investigations for infants presenting with unusual or unexplained clinical manifestations.
• Healthcare providers should exercise extreme caution when using alcohol-based products on or near neonates and infants.