Two-week-old infant with isopropanol intoxication.

Isopropyl alcohol continues to be a frequent toxicologic exposure. However, no cases involving the newborn period have been described. A 14-day-old male infant presented to the emergency department (ED) with the mother's chief complaint that "He is not himself." Physical examination observed the infant to be lethargic and hypotonic. Laboratory evaluation revealed a positive urine drug screen for isopropanol and acetone. Elevated serum levels (in mg/dl) of isopropanol/acetone at 2:45, 4:15, 11:10, and 29:53 hours postpresentation were 101/136, 81/149, 20/155, and 5/72, respectively. Overall, this patient did remarkably well with minimal supportive care and was noted to have a normal neurologic examination within 10 hours of presentation despite rising serum acetone levels. This case brings into question the hypothesis that acetone, a metabolite of isopropanol, prolongs central nervous system depression in acute isopropyl alcohol intoxication. The importance of urine drug screens in children who present to the ED with unusual neurologic examinations is appreciated.