PARACETAMOL POISONING IN AN INFANT

An eight-week old infant with alcohol embryopathy, weighing 3,700 g, w as found to have abnormal liver functions (GPT 312 U/1, Quick value 25 %) after surgical repair of a stenosis of the left ureter at its origi n. The hospital notes indicated that the infant had been given a total of 1.6 g paracetamol over 60 hours for postoperative restlessness and pain. The serum paracetamol level was 60 mg/l 8 hours after the last dose of the drug. Blood exchange transfusion lowered the paracetamol l evel to 11 mg/l within 14 hours. After the exchange transfusion furthe r signs of poisoning, namely renal impairment and a severe encephalopa thy were noted, and Candida was demonstrated in urine, tracheal secret ion and ascites. The renal and, hepatic damage proved reversible under symptomatic treatment. But the child, now 1 year old, is severely ret arded mentally and in its motor functions. These sequelae may be a res idue of the paracetamol poisoning, complications of the clinical cours e or a combination of the two.