The intrathecal penicillin that silenced a boy
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The intrathecal penicillin that silenced a boy
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The intrathecal penicillin that silenced a boy
In this episode, we follow the clinical timeline and legal question after a child with pneumococcal meningitis received an intrathecal penicillin dose thirty times the prescription. The account traces the treatment decisions, the immediate toxic effects, and the unresolved mystery of whether the meningitis or the overdose caused the permanent bilateral deafness.
Person: Andrew Kay
Date: 29 November (in Glasgow), discharged 24 December
Location: Glasgow, Royal Hospital for Sick Children / Queen Mother's Hospital
Event: Intrathecal penicillin overdose (approx. 300,000 units vs prescribed 10,000)
Topic: Whether the overdose or the meningitis caused bilateral profound deafness
- A GP treated Andrew initially for a presumed chest infection with oral ampicillin while he was vomiting and failing to retain medication.
- Consultant Dr. McClure prescribed a targeted intrathecal penicillin dose of 10,000 units after CSF cultures grew pneumococcus.
- Senior house officer Dr. Adam-Strump administered an intrathecal injection that delivered approximately 300,000 units into the subarachnoid space and recognized the error immediately.
- Within minutes Andrew convulsed and developed hemiplegia; acute toxic effects resolved by 1 December and the meningitis cleared faster than expected.
- Bacterial expert Dr. McAllister found zero published cases where intrathecal penicillin overdose was documented to cause deafness, leaving causation disputed and the legal question unresolved.
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