A 10-year-old male with a history of oppositional defiant disorder and attention deficit disorder suffered from mental status changes, nausea, vomiting and tremulousness after intentional ingestion of three over-the-counter cold remedy transdermal patches. Each patch contained approximately 100 mg of camphor. While in the hospital, the patient was treated supportively, with IV fluids and careful monitoring. Before discharge, it was noted that the patient had improved significantly and pediatric neurology documented that the initial presenting symptoms were consistent with camphor toxicity. Our case is unique from other pediatric case reports in the literature because this was an intentional overdose with a specific over-the-counter transdermal product. Education should be given to caregivers regarding appropriate storage of all prescription and over-the-counter medications, household cleaning materials and other potentially toxic chemicals, especially when there are children in the area. Healthcare providers should be aware of the variety of over-the-counter products containing camphor, the complications of overdose, and available treatment strategies.
Key Points
* Camphor ingestion continues to be a source of pediatric exposure and as little as 700-1000 mg may produce clinically significant toxic effects, including death.
* Symptoms such as nausea, vomiting, oral and intestinal burning, feeling of warmth and headache occur rapidly. There is no antidote for camphor toxicity and treatment is largely supportive.
* Guardians must be educated on the proper storage of potentially toxic substances and healthcare providers need to be aware of the many over-the-counter products that may pose a danger.