Lidocaine and prilocaine toxicity in a patient receiving treatment for mollusca contagiosa.

Abstract

We describe a 3-year-old child with mollusca contagiosa whose caregiver applied a eutectic mixture of 5% lidocaine and prilocaine (EMLA) in excessive amounts with the subsequent development of adverse reactions, including methemoglobinemia and hypoxemia. Because of the significant systemic absorption of lidocaine and prilocaine, the patient required overnight admission to the pediatric intensive care unit for close monitoring. A brief description of the proper dosing, pharmacokinetics, and possible side effects of EMLA cream are reviewed.