학술논문
Fatal Diphenhydramine Intoxication in Infants * The opinions and assertions contained herein are the private views of the authors and are not to be construed as those of the Departments of Defense, Army, Air Force, or Navy; the Armed Forces Institute of Pathology; or the Office of the Armed Forces Medical Examiner. Presented orally at the National Association of Medical Examiners (NAME) meeting, Oct. 16, 2001, Richmond, Virginia.
Document Type
journal paper
Author
Source
Journal of Forensic Sciences, Mar 2003, Vol. 48, No. 2, pp. 1-4.
Subject
Language
English
ISSN
0022-1198
Abstract
Diphenhydramine is an antihistamine available in numerous over-the-counter preparations. Often used for its sedative effects in adults, it can cause paradoxical central nervous system stimulation in children, with effects ranging from excitation to seizures and death. Reports of fatal intoxications in young children are rare. We present five cases of fatal intoxication in infants 6, 8, 9, 12, and 12 weeks old. Postmortem blood diphenhydramine levels in the cases were 1.6, 1.5, 1.6, 1.1 and 1.1 mg/L, respectively. Anatomic findings in each case were normal. In one case the child's father admitted giving the infant diphenhydramine in an attempt to induce the infant to sleep; in another case, a daycare provider admitted putting diphenhydramine in a baby bottle. Two cases remain unsolved; one case remains under investigation. The postmortem drug levels in these cases are lower than seen in adult fatalities. We review the literature on diphenhydramine toxicity, particularly as it pertains to small children, and discuss the rationale for treating these cases as fatal intoxications.