[Clonidine poisoning in a child: a case report]. / Intoxication pédiatrique sévère avec une faible dose de clonidine : à propos d'un cas.

Clonidine poisoning's clinical feature is well documented in the medical literature, but the minimal toxic dose has not yet been established. The effectiveness of naloxone is also controversial. The authors describe a clonidine overdose in a 9-year-old boy (25 kg) during a growth hormone test: he received tenfold the prescribed clonidine dose (0.23 mg instead of 0.023 mg) with 6.2 mg betaxolol. About 40 min later, he became drowsy and then complained of low blood pressure, bradycardia, and myosis. By maintaining the Trendelenburg position, administering fluids as well as salbutamol and naloxone (three doses of 0.2 mg were required), he recovered and was discharged from the hospital on day 2. The minimal clonidine toxic dose, the clinical picture, and the effectiveness of naloxone administration are discussed in this paper.

[Methaemoglobinaemia in a child treated with Emla(®) cream: circumstances and consequences of overdose]. / Méthémoglobinémie après application de crème Emla(®) chez un enfant : circonstances et conséquences d'un surdosage.

BACKGROUND: Emla(®) cream, a mixture of two local anaesthetics (prilocaine 2.5%, lidocaine 2.5%) has a good benefit-risk profile. However, methaemoglobinaemia can occur, especially when the cream is applied in excessive amounts or over long periods. PATIENTS AND METHODS: The authors report a case of seizure and respiratory disturbances (MetHb=20.1%) after excessive application of Emla(®) (30g) for curettage of molluscum contagiosum in a young girl with eczema. The patient's clinical condition improved after withdrawal of the cream and administration of methylene blue, and she returned home on day two. DISCUSSION: This new case of methaemoglobinaemia in a child following application of Emla(®) cream highlights the importance of strict compliance with the instructions for use of this medicinal product.