People attempt to use many therapies on children according to their belief systems. Sometimes, these home remedies can backfire and lead to more serious complications. Here, Dr. Anuj Rastogi shares his success story of camphor poisoning, where he encountered an infant brought in an emergency situation and runs us through his experience from diagnosing the condition to treating the case.

Children have unique physiology and express themselves differently. If the drugs used for children are not empirically tried, it may cause poisoning. Described below is one such case I treated recently.

Case description

Recently, I treated a 22-day-old child with a mild cough that was assumed by the child's mother as pneumonia. She tried to cure it by applying vaporub. This practice was followed by another family member who used some more vaporub on the child.

Within the course of an hour, the baby became serious and started showing symptoms- abnormal-looking eyes and limb movements. His whole body was shivering and his family rushed him to the hospital. At the hospital, when we checked, the baby was not breathing; his eyes were dilated and his limbs were cold. His heart was beating, so we intubated him and put him on ventilator support. The child was alive but there was no movement or reaction to pain.

Diagnosis

The diagnosis was tough as we had no clue of what could have caused it and I had to understand the condition before treating it. Was it sepsis, meningitis or brain haemorrhage?

Taking the patient's history

I talked to the family and explained the risk of death in the patient. I tried to gather more information about all the events that happened until the baby reached its current state.

1. The baby was well-built and on mother’s feed (which itself rules out many illnesses).
2. There was no fever, it technically ruled out any infectious cause for deterioration.

I reviewed his previous treatment but failed to understand the deterioration - a child who was smiling an hour ago was now on a ventilator and was struggling for life.

Inference

With my previous experience (about three decades now), I could guess it might be poisoning due to some drug, oil or cream. Slowly I was progressing towards the final diagnosis after almost ruling out other common causes.

My mind was running fast to know what was the main precipitating factor that could have brought the baby to this condition. Finally, after a lot of questioning the family gave details of the repeated usage of Vaporub to relieve his cold. It was clear that it was camphor poisoning.

I now knew it was going to be a fight for life for at least a week, and I was hopeful, as it was due to poisoning. However, there was no test to prove my diagnosis. I ruled out other illnesses by ordering some tests. All the tests were normal.

On day two, the child began moving his limbs and his eyes were reacting to light. He remained on the ventilator for 5 days and on oxygen for the next 7 days and was then safely discharged.

Take-home message for parents and grandparents

Do not try anything unless it is empirically right, whether feeding or treating a minor illness. Here it was Camphor poisoning (Vaporub has Camphor as the main ingredient). A neonate has a three times larger skin surface area compared to an adult, hence drugs are easily absorbed and may cause poisoning. It was a minor viral illness, which turned into a life-threatening situation.

Disclaimer- The views and opinions expressed in this article are those of the author's and do not necessarily reflect the official policy or position of M3 India.

The author is a practising paediatrician from Meerut.