Acute naphazoline poisoning in pre-adolescent: case report.

Abstract

Exogenous poisonings are significant in public health services worldwide, accounting for thousands of cases of morbidity and mortality. Poisonings can result from acute exposure to environmental substances, in water, food or isolated substances such as medicines. In Brazil, in 2017, 11.5% of drug poisoning cases occurred in the pediatric age group, with a peak between the ages of 1 and 4. Sympathomimetic substances used primarily as topical nasal mucosa decongestants, such as naphazoline, are frequently implicated as drug poisoning agents in children, especially younger children. Naphazoline is indicated to relieve the discomfort of nasal obstruction in colds, allergic nasal conditions such as rhinitis, and rhinosinusitis. It is contraindicated for use in children under 12 years old, but it is freely sold in pharmacies, encouraging the harmful practice of self-medication with indiscriminate use and the risk of poisoning. This study reports a case of acute topical nasal naphazoline poisoning in a pre-adolescent in Ribeirão Preto city, São Paulo through medical record and literature review. Mild poisoning was observed, with signs and symptoms of topical nasal naphazoline toxidrome consistent with those described in the literature, and fortunately, a very favorable outcome. This reinforces the need to educate parents and guardians about naphazoline's potential to cause exogenous poisoning.