en عمومى General گزارش مورد case report <div style="text-align: justify;"><span style="color:#000080;"><strong>Background</strong></span>: Incorrect belief about opioid efficacy is a major cause of acute pediatric poisonings in Iran. We report a rare case of topical opium application that caused death in a 4-year-old child.&nbsp;<br> <span style="color:#000080;"><strong>Case</strong></span>: A 4-year old girl was examined with burns over her abdominal area and lower extremities. Her parents had applied opium on burned area to relieve her pain. She was in delirium state and apnea without any evidence of infection. Immediately, she was administered a single dose of Naloxone (2mg).&nbsp;<br> <span style="color:#000080;"><strong>Results</strong></span>: While blood oxygen saturation was improving, she aspirated her vomitus into the lungs and became hypotensive and pulseless. Her condition deteriorated and the treatment team&rsquo;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.&nbsp;<br> <span style="color:#000080;"><strong>Conclusion</strong></span>: The plausible contributing factors may include: change in morphine pharmacokinetics in the burned skin; the low toxic dose of opium in children due to thin abdominal skin, and high blood perfusion in the burned areas.</div> Dermal, opium, children, death, Iran, forensic toxicology Dermal, Opium, Children death, Iran, Forensic toxicology 59 62 http://ijt.arakmu.ac.ir/browse.php?a_code=A-10-303-2&slc_lang=en&sid=1 Mohammad Moshiri محمد مشیری Moshirim@mums.ac.ir 100319475328460010587 100319475328460010587 No Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Arya Hedjazi آریا حجازی Aryahedjazi@gmail.com 100319475328460010588 100319475328460010588 No Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. Seyed Mohsen Rezazadeh-Shojaie سید محسن زضا زاده شجاعی Reazazadehsmm@yahoo.com 100319475328460010589 100319475328460010589 No Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. Leila Etemad لیلا اعتماد etemadl@mums.ac.ir 100319475328460010590 100319475328460010590 Yes Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran. مرکز تحقیقات عوم دارویی