Accidental poisoning in children, though underreported in our environment, is common and could prove fatal. It is important to identify the primary chemical agent that is responsible for the poisoning. We present a case of accidental ingestion of fish poisoned with aluminum phosphide (AlP) used as rat poisoning by a 14-month-old girl. At presentation, the actual chemical content of the poison was not available and clinical features were suggestive of organophosphate poisoning. She was commenced on atropine together with other treatment, on which she made remarkable improvement. The atropine was continued with complete resolution of symptoms on the third day of admission. We, therefore, report a serendipitous use of atropine in the management of AlP poisoning with successful outcome.

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sophageal variceal bleeding, though rare in children, remains a major cause of significant morbidity and mortality [1,2]. It may results in rapid depletion of the circulatory volume in children, as a result of their relatively small total blood volume [3]. Hence, effective resuscitation followed by prompt diagnosis, controlling of bleeding, and prevention of complications are important steps in the management of acute variceal bleeding [4]. In children, portal hypertension (PHT) from portal vein thrombosis (PVT) is the most common etiology of esophageal varices [1,5]. Risk factors for this include neonatal umbilical catheterization, omphalitis, neonatal sepsis with abdominal focus, and dehydration [6,7]. These factors result in PVT and subsequent disruption of blood flow throw the portal system leading to PHT [8]. The umbilical venous access (through umbilical catheterization) is one of the most commonly used routes for blood transfusion, intravenous fluids, and drug administration as well as parenteral nutrition in preterm neonates [9]. Catheter tip malposition, infection, and prolonged duration increase the risk of PVT [1]. We, therefore, report a case of bleeding esophageal varices in a 9-month-old infant who had umbilical catheterization

Levamisole-induced thrombocytopenia and vasculitis are rare entities in children. Here, we report a 5-year-old male who presented with complaints of purpuric rashes and nasal and gum bleeding for 24 h following intake of single high-dose levamisole for presumptive treatment of helminthiasis. No preceding symptoms of viral infection or bleeding into closed spaces were noted. He was clinically stable except for maculopapular and patchy purpuric rashes on the face, neck, and trunk. No hepatosplenomegaly or lymphadenopathy was observed. Full blood count and blood film showed severe thrombocytopenia of 6.00 × 109/L and platelets left shift with dysplastic neutrophils. He was commenced on prednisolone and transfused with fresh whole blood. The patient improved remarkably and showed reversal of hematological parameters within 48 h. Further, full blood count examination showed reactive thrombocytosis. Levamisole induces reversible thrombocytopenia by immune-mediated cytotoxic destruction of the platelets and white blood cells.

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