2-WEEK-OLD INFANT WITH ISOPROPANOL INTOXICATION

Isopropyl alcohol continues to be a frequent toxicologic exposure. How ever, no cases involving the newborn period have been described. A 14- day-old male infant presented to the emergency department (ED) with th e mother's chief complaint that ''He is not himself.'' Physical examin ation observed the infant to be lethargic and hypotonic. Laboratory ev aluation revealed a positive urine drug screen for isopropanol and ace tone. Elevated serum levels (in mg/dl) of isopropanol/acetone at 2:45, 4:15, 11:10, and 29:53 hours postpresentation were 101/136,81/149, 20 /155, and 5/72, respectively. Overall, this patient did remarkably wel l with minimal supportive care and was noted to have a normal neurolog ic examination within 10 hours of presentation despite rising serum ac etone levels. This case brings into question the hypothesis that aceto ne, a metabolite of isopropanol, prolongs central nervous system depre ssion in acute isopropyl alcohol intoxication. The importance of urine drug screens in children who present to the ED with unusual neurologi c examinations is appreciated.