Methemoglobinemia secondary to automobile exhaust fumes.
Methemoglobinemia is an uncommon cause of cyanosis. A 28-year-old male presented to the emergency department cyanotic and short of breath after exposure to noxious automobile fumes. He did not improve with the administration of 100% oxygen therapy. The initial arterial blood gas with cooximetry was: pH of 7.38, PaCO2 of 43 mm Hg, PaO2 of 118 mm Hg, measured oxygen saturation of 70%, and a methemoglobin level of 24.8%. Methylene blue was given (2 mg/kg intravenously) and the patient's symptoms resolved. On the following day he was discharged home without complication. A comprehensive review of the literature revealed no reported cases of methemoglobinemia secondary to accidental exposure to exhaust fumes.
Laney
R F
RF
Department of Emergency Medicine, Morristown Memorial Hospital, NJ.
Hoffman
R S
RS
D000328:Adult; D001784:Blood Gas Analysis; D006801:Humans; D008297:Male; D008706:Methemoglobin / Q000032:analysis; D008708:Methemoglobinemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D008751:Methylene Blue / Q000627:therapeutic use; D010102:Oxygen Inhalation Therapy; D001335:Vehicle Emissions / Q000506:poisoning*
D001335:Vehicle Emissions; D008706:Methemoglobin; D008751:Methylene Blue