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Pediatric emergency care · Sep 2011
Case ReportsToxic leukoencephalopathy due to transdermal fentanyl overdose.
- Lindsey Foy, Desiree M Seeyave, and Stuart A Bradin.
- Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA.
- Pediatr Emerg Care. 2011 Sep 1;27(9):854-6.
AbstractChildren with altered mental status who present to the emergency department have a broad differential diagnosis. We report a case of a 19-month-old girl who presented in coma and who was later found to have a fentanyl patch adhered to her back. She was found to have changes on brain magnetic resonance imaging consistent with a toxic spongiform leukoencephalopathy but had a good neurologic outcome. This case report illustrates the importance of a thorough physical examination in children in coma and a rarely reported magnetic resonance imaging finding that has been seen in opioid intoxication and is usually associated with severe morbidity and mortality.
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