FATAL PARAPHENYLENEDIAMINE (HAIR DYE) INTOXICATION IN A CHILD RESEMBLING LUDWIGS ANGINA

A 6 year-old child with paraphenylenediamine intoxication is presented . The patient suffered from sore throat, cough, and anorexia, followed by severe dyspnea caused by edema of the tongue, pharynx, and neck, r enal failure. and metabolic acidosis. A presumptive diagnosis of Ludwi g's angina, a severe anaerobic infection of the sublingual neck space, was entertained. Despite institution of vigorous supportive therapy a nd administration of antibiotics, the child developed irreversible ven tricular fibrillation and died eight hours after admission. Two days a fter the patient's death, his father recalled that the child and his d og ingested an unidentified substance shortly before the onset of the child's symptoms. The dog died within a few hours. The substance was i dentified as the hair dye, paraphenylenediamine.