An unexpected clinical course in a 29-day-old infant with ethanol exposure.
Ethanol exposure can affect all pediatric age groups but occurs most commonly in ambulatory children and adolescents. Infants are less likely to ingest ethanol because they have limited ability to explore their environments. However, ethanol exposures in infants can occur. We report the case of a 29-day-old (3.5 kg) baby girl who presented with a blood alcohol level of 301 mg/dL after ingesting formula that had been prepared with gin. To our knowledge, she is the youngest reported child with such an elevated ethanol level in the medical literature. Despite her markedly elevated blood alcohol level, she had an unexpectedly mild clinical course, exhibiting subtle neurologic symptoms but no hypothermia, hypoglycemia, or cardiorespiratory impairment. This case demonstrates that the ethanol-exposed infant may lack typical or clear symptoms of acute intoxication. Therefore, the clinician must have a low threshold for pursuing blood alcohol testing in infants and young children with altered mental status. A prompt diagnosis of ethanol exposure is important for ensuring the health and safety of the child.
From the *Department of Pediatrics, The Children's Hospital of Philadelphia; Robert Wood Johnson Foundation Clinical Scholars Program and Leonard Davis Institute of Health Economics, The Perelman School of Medicine at the University of Pennsylvania; and †The Institute for Continuing Healthcare Education and the University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA.
Hiu-Fai
HF
Fong
Allison A
AA
Muller
D000435:Alcoholic Intoxication / Q000175:diagnosis / Q000628:therapy; D000431:Ethanol / Q000097:blood / Q000506:poisoning*; D005260:Female; D006801:Humans; D041943:Infant Formula; D007231:Infant, Newborn
D000431:Ethanol