CNS toxicity after topical application of EMLA cream on a toddler with molluscum contagiosum.
EMLA (eutectic mixture of local anesthetics) cream is used topically to provide local anesthesia for a variety of painful superficial procedures. Although the side effects of EMLA are usually mild and transient local skin reactions, potential life threatening complications can be encountered. We report a case of central nervous toxicity after EMLA application for curettage of molluscum contagiosum lesions in a pediatric patient. This complication was the result of a therapeutic misadventure that led to an excessive application of EMLA cream over an extensive area causing an overdose of lidocaine and prilocaine with their subsequent systemic toxicities.
Rincon
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Division of Emergency Medicine, Miami Children's Hospital, Florida 33155, USA.
Baker
R L
RL
Iglesias
A J
AJ
Duarte
A M
AM
D000287:Administration, Topical; D019162:Anesthetics, Combined / Q000008:administration & dosage / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D002490:Central Nervous System / Q000187:drug effects; D005260:Female; D006801:Humans; D007223:Infant; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects*; D008508:Medication Errors; D008976:Molluscum Contagiosum / Q000601:surgery*; D009824:Ointments; D011318:Prilocaine / Q000008:administration & dosage / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced*
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine