Background: Emla(®) cream, a mixture of two local anaesthetics (prilocaine 2.5%, lidocaine 2.5%) has a good benefit-risk profile. However, methaemoglobinaemia can occur, especially when the cream is applied in excessive amounts or over long periods.
Patients and methods: The authors report a case of seizure and respiratory disturbances (MetHb=20.1%) after excessive application of Emla(®) (30g) for curettage of molluscum contagiosum in a young girl with eczema. The patient's clinical condition improved after withdrawal of the cream and administration of methylene blue, and she returned home on day two.
Discussion: This new case of methaemoglobinaemia in a child following application of Emla(®) cream highlights the importance of strict compliance with the instructions for use of this medicinal product.
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