Acute Poisoning with Dentocalmin -a Life-threatening Entity in Children

• Published in: Clinical toxicology (Philadelphia, Pa.) Vol. 45; no. 4; p. 351
• Main Authors: Nitescu, G V, Ulmeanu, CE, Cristache, C
• Format: Journal Article
• Language: English
• Published: 01-05-2007
• ISSN: 1556-3650

Objective: To describe signs and symptoms of a new severe poisoning in children - Dentocalmin poisoning. Dentocalmin is a pharmaceutical product used in stomatology as a local anaesthetic, containing in 10 mL: lidocaine 2 g, menthol 2 g and phenol 2 g. We present a series of 7 cases registered in our Department over a period of 5 years. Case Series: 1. A 1-year-old boy who ingested an unknown quantity of Dentocalmin presented with generalized tonic-clonic seizures that could not be stopped with anticonvulsants; one hour after arrival he presented with cardio-respiratory arrest and died. 2. A 2-month-old female infant was taken to the Emergency Department presenting with cardio-respiratory arrest; her mother related that 30 minutes earlier she gave the infant an unknown quantity of Dentocalmin instead of vitamin D3 solution; the infant was resuscitated, intubated and ventilated for 48 hours; she developed generalised seizures 1 hour after admission; she was discharged 6 days later completely recovered. 3. A girl of 1 year and 4 months old who ingested 10 mL of this product became agitated, then developed seizures and respiratory arrest at the moment of admission; she was intubated, treated with diaz-epam and midazolam for convulsions; the progress was favorable: she was extubated 3 hours later and discharged after 3 days. 4. A girl of 2 years and six months with the same history presented with generalized seizures, then became cyanotic with bradypnoea; was intubated for 6 hours and treated with diazepam. 5 and 6. Two boys 2 years and 3 years old who had ingested an unknown quantity of the product came in the first hour to the Emergency Department presenting with somnolence, hypotonia and sinus tachycardia; no other symptoms appeared and they were sent home 3 days later. 7. A 7-month-old female infant was admitted 30 minutes after her mother gave her 2 drops of Dentocalmin instead vitamin D3; she presented with agitation, ataxia, sinus tachycardia and completely recovered. Conclusion: Dentocalmin is a very toxic product that causes life threatening symptoms and even death in children. This clinical picture is probably due to its composition with high doses of lidocaine, menthol and phenol in a small volume.