Chemistry set poisoning.

A prospective survey of chemistry set poisoning (CSP) was undertaken using the monthly postal enquiry report system of the British Paediatric Surveillance Unit (BPSU). Fourteen cases were reported, with one fatality and uneventful full recovery in the other 13. The packaging of the chemicals was unsatisfactory in all cases: it was not child resistant and had no proper closures. Risk factors were lack of supervision 64.3%, emotional factors 28.6%, genuine accident 7% and unidentified 7%. An additional retrospective survey of CSP reported to the National Poisons Information Service centres over the same period added a further 19 cases of CSP, making a total of 33 cases, 14 (42%) being due to copper sulphate and four (12%) to cobalt chloride, respectively. This survey showed CSP to be a significant problem, with an incidence of 0.3 cases per 100,000 children. Six recommendations were made concerning child-resistant containers, toxic hazard warnings, size and content of the lettering, health education programmes targeted at the most vulnerable groups, and lastly, a legal restriction on the chemicals that can be included in these sets, so that the most toxic are excluded.

Neonatal cross-infection with Listeria monocytogenes.

Transmission of Listeria monocytogenes by food continues to cause concern. Even so, this is not the only means of transmission and neonatal hospital-acquired infection has been well recorded. We report here two cases of perinatal listeriosis one of which was likely to have been due to cross-contamination in a Special Care Baby Unit (SCBU) with equipment acting as the vehicle.

Pancreatic ascites in childhood.

A case is reported of pancreatic ascites in a 14-year-old girl who had acute and chronic pancreatitis associated with pancreatic duct stones and a ruptured pancreatic duct. Abdominal erythema ab igne was considered to be an important physical sign of genuine severe abdominal pain.

A case of cardio-facio-cutaneous syndrome.

A 6-yr-old girl is described who presented with failure to thrive at age 3 months and was found to have mental retardation, growth retardation, disproportionately large head, distinctive face, abnormal hair, eczema, heart defect, splenomegaly, and multiple hemangiomata. She is thought to have the cardio-facio-cutaneous syndrome and to be the first such case identified in Britain.

Obstructive sleep apnoea causing severe pulmonary hypertension reversed by emergency tonsillectomy.

A three-year-old boy is reported with severe upper respiratory tract obstruction and sleep apnoea that was associated with reversible pulmonary hypertension and cardiac enlargement, and relieved by emergency tonsillectomy. The importance of intermittent cyanosis and difficulty in arousal during the day are stressed, together with the risk of death from anaesthesia in such patients without full pre-operative assessment. Despite this risk, and the current climate of increasing reluctance to subject children to tonsillectomy, the operation is absolutely essential and potentially lifesaving in certain children such as the boy described.

Accidental feeding of a dilute antiseptic solution (chlorhexidine 0.05% with cetrimide 1%) to five babies.

Five normal newborn breast fed babies were accidentally fed a dilute antiseptic solution (chlorhexidine 0.05% with cetrimide 1%) in place of sterile water, developing caustic burns of the lips, mouth and tongue within minutes; one baby became quite severely ill due to acute pulmonary oedema, but all survived without sequelae.