Coma Produced by Topical Application of Isopropanol

The topical use of isopropyl alcohol to reduce fever in children is a common procedure in pediatric practice. Deep coma has been reported in two children, presumably from inhalation of the alcohol during sponging procedures in poorly ventilated areas.^1,2 Absorption through the skin has not been reported to be a significant portal of entry.³ The toxic effects of ingested isopropanol in humans are reported to be similar to those of ethanol, but they occur at lower blood concentrations.⁴ The lethal dose for adults of ingested 70% isopropyl alcohol has been estimated to be 240 ml.⁵ The following case is reported as an example of coma in an infant following injudicious topical application of isopropanol for the relief of fever.