{'fraction_non_alphanumeric': 0.025215252152521524, 'fraction_numerical': 0.007995079950799507, 'mean_word_length': 4.708771929824562, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Cetrimide allergy presenting as suspected non-accidental injury

A 20-month-old boy was admitted to the paediatric ward after presenting to casualty with a large burn on the right pectoral area (figure). He was the product of a normal pregnancy and there was no history of note except a head injury sustained at 15 months. There was no history of allergy. He came from an unstable family background, the mother being unmarried and cohabiting with a man who was not his father. In the early hours of the morning of admission he had woken screaming, having previously been well. Six hours later a general practitioner had been called to see the child but had found no reason for his behaviour. During the subsequent 10 hours an area of erythema 14 x 8 cm, including a central area of blistering with bullae formation, developed on the right chest wall. He presented in the accident and emergency department and was admitted. Because no explanation was forthcoming possible non-accidental injury was diagnosed and a case conference called. Investigation by the police and social services concluded the lesion to be accidental in origin. Exhaustive inquiry established that shampoo containing cetrimide 12 °, had been spilled on to the child's chest, while he was unattended, on the eve of admission. A control experiment was performed, with the mother's consent, and a small quantity of cetrimide (12 % solution) was applied to the left chest. This produced a lesion identical with the first. Both lesions were treated with silver sulphadiazine ointment, 'N' for Burns, and non-adhesive dressings. He made good cosmetic recovery.