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Coma Following Use of Rubbing Alcohol for Fever Control

Coma Following Use of Rubbing Alcohol for Fever Control Abstract Sir.— The topical use of isopropyl alcohol for fever control in children was once on accepted pediatric practice. Since the late 1950s, this practice has been discouraged following reports of neurotoxic effects that include stupor, narcosis, coma, and even death.1,2 Unfortunately, sponging with rubbing alcohol remains a fairly common method for fever control in children in some communities. We describe a patient with coma secondary to sponging with isopropyl and discuss the clinical clues for the diagnosis. Patient Report.—Fever to 40°C developed in a previously healthy 18-month-old girl while she was being treated with amoxicillin for otitis media. In an attempt to lower her temperature, her mother repeatedly wrapped towels absorbed with rubbing alcohol around the child's waist for periods of up to four hours. The child became progressively lethargic and ultimately unresponsive to verbal and tactile stimulation. At the time she arrived at our intensive care unit, she was unconscious and unresponsive to pain, with midline fixed miotic pupils, References 1. SenzEH, Goldfarb DL: Coma in a child following use of isopropyl alcohol in sponging . J Pediatr 1958;53:322-323.Crossref 2. McFaddenSW, Haddow JE: Coma produced by topical application of isopropanol Pediatrics 1969;43:622-623. 3. LacouturePG, Wason S, Abrams A, et al: Acute isopropyl alcohol intoxication . Am J Med 1983;75:680-686.Crossref 4. NordmannR, Ribiere C, Rouach H, et al: Metabolic pathways involved in the oxidation of isopropanol into acetone by the intact rat . Life Sci 1973;13:919-931.Crossref 5. AdelsonL: Fatal intoxication with isopropyl alcohol . Am J Clin Pathol 1962;38:144-151. 6. MecikalskiMB, Depner TA: Peritoneal dialysis for isopropanol poisoning . West J Med 1982; 137:322-324. 7. Webster HC, Shutack JG, Norman ME, et al: Diagnostic clinical osmometry in the unconscious infant . Crit Care Med 1985;13:1076-1077.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Coma Following Use of Rubbing Alcohol for Fever Control

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460030015001
Publisher site
See Article on Publisher Site

Abstract

Abstract Sir.— The topical use of isopropyl alcohol for fever control in children was once on accepted pediatric practice. Since the late 1950s, this practice has been discouraged following reports of neurotoxic effects that include stupor, narcosis, coma, and even death.1,2 Unfortunately, sponging with rubbing alcohol remains a fairly common method for fever control in children in some communities. We describe a patient with coma secondary to sponging with isopropyl and discuss the clinical clues for the diagnosis. Patient Report.—Fever to 40°C developed in a previously healthy 18-month-old girl while she was being treated with amoxicillin for otitis media. In an attempt to lower her temperature, her mother repeatedly wrapped towels absorbed with rubbing alcohol around the child's waist for periods of up to four hours. The child became progressively lethargic and ultimately unresponsive to verbal and tactile stimulation. At the time she arrived at our intensive care unit, she was unconscious and unresponsive to pain, with midline fixed miotic pupils, References 1. SenzEH, Goldfarb DL: Coma in a child following use of isopropyl alcohol in sponging . J Pediatr 1958;53:322-323.Crossref 2. McFaddenSW, Haddow JE: Coma produced by topical application of isopropanol Pediatrics 1969;43:622-623. 3. LacouturePG, Wason S, Abrams A, et al: Acute isopropyl alcohol intoxication . Am J Med 1983;75:680-686.Crossref 4. NordmannR, Ribiere C, Rouach H, et al: Metabolic pathways involved in the oxidation of isopropanol into acetone by the intact rat . Life Sci 1973;13:919-931.Crossref 5. AdelsonL: Fatal intoxication with isopropyl alcohol . Am J Clin Pathol 1962;38:144-151. 6. MecikalskiMB, Depner TA: Peritoneal dialysis for isopropanol poisoning . West J Med 1982; 137:322-324. 7. Webster HC, Shutack JG, Norman ME, et al: Diagnostic clinical osmometry in the unconscious infant . Crit Care Med 1985;13:1076-1077.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Mar 1, 1987

References