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a St
Mary's NHS Trust, Praed Street, London W2 1NY, b Medical Toxicology Unit, Guy's
and St Thomas's Hospital, St Thomas Street, London SE1 9RT
Correspondence to: Dr Davies, Department of Paediatrics, Luton and Dunstable Hospital, Lewsey Road, Luton LU4 ODZ, UK daviespatrick{at}hotmail.com
We present a case of severe acute nicotine poisoning in an 8 year old boy with moderate eczema after topical application of a
traditional remedy from a book published in Bangladesh. Symptoms consistent with nicotine poisoning developed within 30 minutes of
application of the remedy. The child subsequently improved with
supportive care and was discharged after five days with no neurological
sequelae. Diagnosis of nicotine poisoning was not initially made due to
difficulty in obtaining an accurate history via an interpreter from the
parents who did not speak English. Samples taken 12 hours after
application of the remedy showed a serum nicotine of 89 µg/l, serum
cotinine of 1430 µg/l, urine nicotine of 1120 µg/l, and a urine
cotinine of 6960 µg/l confirming acute nicotine poisoning.
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