ISOPROPYL-ALCOHOL INTOXICATION IN A NEONATE THROUGH CHRONIC DERMAL EXPOSURE - A COMPLICATION OF A CULTURALLY-BASED UMBILICAL CARE PRACTICE

A 21-day-old boy presented to our emergency department hypotonic, leth argic, and intermittently unresponsive to pain. A workup for ketoacido sis, sepsis, and central nervous system hemorrhage was negative. A uri ne drug screen collected eight hours after hospitalization showed 39 m g/dl of isopropyl alcohol and 76 mg/dl of acetone. The first serum dru g analysis was not performed until 18 hours after admission, at a time when there had been clinical improvement. The isopropyl alcohol conce ntration was 8 mg/dl, and the acetone concentration was 203 mg/dl. Man agement was supportive, and the patient stabilized. He was discharged from the hospital in good health in three days. A further review of th e history showed no evidence for an oral exposure to isopropyl alcohol . However, since leaving the maternity hospital the mother had been ap plying gauze pads or cotton balls soaked with isopropyl alcohol to the umbilicus with every diaper change. We conclude that the child suffer ed from an isopropyl alcohol intoxication that occurred by absorption through the umbilical area.