Illustrative Cases: PDF OnlyIsopropyl alcohol intoxication in a neonate through chronic dermal exposure: A complication of a culturally-based umbilical care practiceVIVIER, PATRICK M. MD1; LEWANDER, WILLIAM J. MD1,2; MARTIN, HORACE F. MD, PhD3; LINAKIS, JAMES G. PhD, MD1,2Author Information 1From the Department of Pediatrics, Brown University and Rhode Island Hospital, Providence, Rhode Island 2From the Division of Pediatric Emergency Medicine and the Section of Emergency Medicine, Brown University and Rhode Island Hospital, Providence, Rhode Island 3From the Section of Clinical Chemistry Department of Pathology, Brown University and Rhode Island Hospital, Providence, Rhode Island Pediatric Emergency Care: April 1994 - Volume 10 - Issue 2 - p 91-93 Buy Abstract A 21-day-old boy presented to our emergency department hypotonic, lethargic, and intermittently unresponsive to pain. A workup for ketoacidosis, sepsis, and central nervous system hemorrhage was negative. A urine drug screen collected eight hours after hospitalization showed 39 mg/dl of isopropyl alcohol and 76 mg/dl of acetone. The first serum drug analysis was not performed until 18 hours after admission, at a time when there had been clinical improvement. The isopropyl alcohol concentration was 8 mg/dl, and the acetone concentration was 203 mg/dl. Management was supportive, and the patient stabilized. He was discharged from the hospital in good health in three days. A further review of the history showed no evidence for an oral exposure to isopropyl alcohol. However, since leaving the maternity hospital the mother had been applying gauze pads or cotton balls soaked with isopropyl alcohol to the umbilicus with every diaper change. We conclude that the child suffered from an isopropyl alcohol intoxication that occurred by absorption through the umbilical area. © Lippincott-Raven Publishers.