Successful treatment of dinitrophenol poisoning in a child.
BACKGROUND: Poisoning with agricultural toxins is well known in the adult environment, but is rarely seen in children. Vancouver, British Columbia, borders on a large agricultural area, and the British Columbia Children's Hospital is the provincial referral center for major pediatric emergencies. In our experience, children from farming communities are vulnerable to a range of agriculturally related injuries, and exposure to toxic chemicals requiring hospitalization is not rare. METHODS: This is a case report with literature review. RESULTS: A child presenting in a coma proved later to have been exposed to a toxic agent. The agent, dinitrophenol, is a widely used agricultural herbicide and insecticide. The diagnosis resulted from a detailed history and physical examination, which revealed symptoms and signs that suggested poisoning. A search of the farm resulted, and the parents located open dinitrophenol containers. The toxic effects of dinitrophenol described in adults by Poison Control matched those present in the child, and specific treatment interventions existed that could be implemented to positively influence outcome. CONCLUSIONS: Awareness of the possibility of exposure to dinitrophenol is required, as death can result from exposure, and milder cases may go unrecognized. Appropriate treatment can improve outcome. Injuries with toxic agricultural agents are wholly preventable if the materials are handled appropriately in the farm environment, and parents whose children live on or visit farms are aware of the risks involved and take appropriate precautions.