Abstract
BackgroundIn contrast to intoxications in toddlers which can be due to accidental ingestions, many intoxications in infants are due to medication errors. To our knowledge, this is the first case report of a citalopram intoxication in an infant, and may offer new insight on possible screening methods for intoxication as well as pharmacokinetics of citalopram in small infants.Case presentationThis case report describes an unintentional citalopram intoxication in a 4 week old infant due to a vitamin D drops ‘look alike’ error. The infant showed extreme jitteriness and opisthotonus at presentation, as well as prolonged signs of gastro-oesophageal reflux. No cardiac rhythm disturbances or convulsions were seen. The clinical course combined with Finnegan scores was correlated to and supported by pharmacokinetic and pharmacokinetic data of citalopram in the patient.ConclusionsUsing Finnegan scores in general pediatric practice could help objectify follow-up of acute intoxications in young infants with neurological symptoms.
Highlights
In contrast to intoxications in toddlers which are often due to accidental ingestions, many intoxications in infants are due to medication errors [6]
During the time of admittance at the neonatal intensive care unit (NICU), Finnegan scores were not measured. In this case report we presented a 4 week old infant which was accidently given 20 mg citalopram resulting in a dose of 6.0 mg/kg, being around 30 times a ‘recommended’ dose in older children
While the Finnegan scores seemed to correlate to neurological course during admission, it did not adequately correlate to the gastro-intestinal symptoms that persisted like the GER and increased muscle tone
Summary
In contrast to intoxications in toddlers which can be due to accidental ingestions, many intoxications in infants are due to medication errors. Conclusions: Using Finnegan scores in general pediatric practice could help objectify follow-up of acute intoxications in young infants with neurological symptoms. At ambulant follow-up, the patient showed persistent signs of increased muscle tone for at least 1 month after discharge.
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