Hemorrhagic gastritis from topical isopropanol exposure.
OBJECTIVE
To report the occurrence of hemorrhagic gastritis after topical isopropanol application in an infant.


METHODS
A 2-year-old Hispanic boy developed coffee-ground emesis during emergency department evaluation for lethargy and fever. After an initial inconclusive workup for sepsis, further history revealed an isopropanol rubdown for fever reduction. Isopropanol concentrations and acetone metabolites were elevated, the patient recovered with supportive therapy, and other causes for hemorrhagic gastritis were excluded.


CONCLUSIONS
Isopropanol sponge bathing is commonly used as a home remedy for infants with fever. Topical absorption of isopropanol has previously been reported to cause mental status changes, ketosis, and metabolic acidosis. We report a case of hemorrhagic gastritis as a complication of topical isopropanol absorption in a febrile infant. An objective causality assessment revealed that the adverse event was probably caused by the isopropanol. Previous reports of pediatric isopropanol poisoning and its management are discussed.


CONCLUSIONS
Severe morbidity from topical isopropanol exposure may occur in young children.
Dyer
Sara
S
Northwestern Memorial Hospital, Chicago, IL, USA.
Mycyk
Mark B
MB
Ahrens
William R
WR
Zell-Kanter
Michele
M
D019840:2-Propanol / Q000008:administration & dosage / Q000009:adverse effects*; D000287:Administration, Topical; D002675:Child, Preschool; D005756:Gastritis / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D008297:Male; D012869:Skin Absorption
D019840:2-Propanol