An Unexpected Clinical Course in a 29-Day-Old Infant With Ethanol Exposure

Abstract

Ethanol exposure can affect all pediatric age groups but occurs most commonly in ambulatory children and adolescents. Infants are less likely to ingest ethanol because they have limited ability to explore their environments. However, ethanol exposures in infants can occur. We report the case of a 29-day-old (3.5 kg) baby girl who presented with a blood alcohol level of 301 mg/dL after ingesting formula that had been prepared with gin. To our knowledge, she is the youngest reported child with such an elevated ethanol level in the medical literature. Despite her markedly elevated blood alcohol level, she had an unexpectedly mild clinical course, exhibiting subtle neurologic symptoms but no hypothermia, hypoglycemia, or cardiorespiratory impairment. This case demonstrates that the ethanol-exposed infant may lack typical or clear symptoms of acute intoxication. Therefore, the clinician must have a low threshold for pursuing blood alcohol testing in infants and young children with altered mental status. A prompt diagnosis of ethanol exposure is important for ensuring the health and safety of the child.

Ethanol Pharmacokinetics in Neonates and Infants

“…A study from the Children’s Hospital of Philadelphia described a 29-day old baby with an initial ethanol level 301 mg/dL 71 . The child had a mild clinical course with subtle neurologic symptoms and made a full recovery.…”

Toxicology and the biological role of methanol and ethanol: Current view

“…Though adults are quite resistant to ethanol and most cases can be successfully treated, children are highly vulnerable and ethanol intake can have serious consequences including life threating states. This fact is evidenced in the stated case reports 149,150 . With accidental methanol poisoning, the effects are much more serious and grave than with ethanol.…”

Neonatal acute ethanol intoxication during the epidemic of COVID-19: a case report

“…Ethanol intoxication is uncommon in children, especially neonates [ 7 ]. According to previous reports, the clinical symptoms of acute ethanol intoxication are non-specific, and can be confused with other diseases, such as encephalitis, hydrocephalus, and anaphylactic shock [ 7 , 8 ].Therefore, we reported a case of acute ethanol intoxication in a 25-day-old newborn boy to raise awareness of the disease.…”