child death due to dermal opium application: a case report

Background: incorrect belief about opioid efficacy is a major cause of acute pediatricpoisonings in iran. we report a rare case of topical opium application that caused death in a4-year-old child.case: a 4-year old girl was examined with burns over her abdominal area and lowerextremities. her parents had applied opium on burned area to relieve her pain. she was indelirium state and apnea without any evidence of infection. immediately, she was administereda single dose of naloxone (2 mg).results: while blood oxygen saturation was improving, she aspirated her vomitus into thelungs and became hypotensive and pulseless. her condition deteriorated and the treatmentteam’s efforts to resuscitate her failed. on her autopsy, there were no other abnormal findings,but codeine and morphine were detected in the autopsied tissue sample.conclusion: the plausible contributing factors may include: change in morphinepharmacokinetics in the burned skin; the low toxic dose of opium in children due to thinabdominal skin, and high blood perfusion in the burned areas.