Abstract
IntroductionN-acetylcysteine has proven to be effective in paracetamol intoxications, but there is no consensus regarding its way of administration. Here, we report a case to highlight the importance of careful management of intravenous n-acetylcysteine.Case presentationA two-month old infant was seen in our paediatric emergency department due to paracetamol poisoning after repeated supratherapeutic doses. She was treated with intravenous n-acetylcysteine diluted with dextrose 5%, according to the 20-hour standard protocol. Eight hours later she developed two tonic-clonic seizures and was subsequently intubated. By that time, she had received almost 1 liter of 5% dextrose, and serum sodium was 114 mg/dL. A rapid correction was done with hypertonic saline and the child experienced a good outcome, without any sequelae.ConclusionIntravenous n-acetylcysteine administration must be done carefully. Amount of liquid administrated and sodium monitoring should be kept in mind, with special care in small children.
Highlights
N-acetylcysteine has proven to be effective in paracetamol intoxications, but there is no consensus regarding its way of administration
Case presentation: A two-month old infant was seen in our paediatric emergency department due to paracetamol poisoning after repeated supratherapeutic doses
Case presentation A two-month old Caucasian Spanish infant was seen in our pediatric emergency department (PED) because of paracetamol overdosing
Summary
Paracetamol is a worldwide-used, safe and effective antipyretic and analgesic for children when used at therapeutic doses. Activated charcoal is useful to lower intestinal absorption when ingestion takes place within the previous 60 to 90 minutes [3,7] This medication achieves its highest serum levels about Here, we present a case, which derived in a life-threatening four hours after ingestion [3]. Case presentation A two-month old Caucasian Spanish infant was seen in our pediatric emergency department (PED) because of paracetamol overdosing. She was febrile due to vaccination and her parents gave her three consecutive doses of 500 mg instead of 50 mg of paracetamol (weight 4.7 kg), separated by 6 hours. She was followed up as an outpatient during the following months, and her neurological status was completely normal
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