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Coma Following Use of Rubbing Alcohol for Fever Control

Moshe Arditi, MD; Marta S. Killner, MD
Am J Dis Child. 1987;141(3):237-238. doi:10.1001/archpedi.1987.04460030015001.
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Sir.— The topical use of isopropyl alcohol for fever control in children was once on accepted pediatric practice. Since the late 1950s, this practice has been discouraged following reports of neurotoxic effects that include stupor, narcosis, coma, and even death.1,2 Unfortunately, sponging with rubbing alcohol remains a fairly common method for fever control in children in some communities. We describe a patient with coma secondary to sponging with isopropyl and discuss the clinical clues for the diagnosis.

Patient Report.—Fever to 40°C developed in a previously healthy 18-month-old girl while she was being treated with amoxicillin for otitis media. In an attempt to lower her temperature, her mother repeatedly wrapped towels absorbed with rubbing alcohol around the child's waist for periods of up to four hours. The child became progressively lethargic and ultimately unresponsive to verbal and tactile stimulation. At the time she arrived at our intensive care unit, she was unconscious and unresponsive to pain, with midline fixed miotic pupils,


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