title: Methemoglobinemia secondary to automobile exhaust fumes.
abstract: 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.
authors.affiliation: Department of Emergency Medicine, Morristown Memorial Hospital, NJ.
authors.forename: R F
authors.initials: RF
authors.lastname: Laney
authors.forename: R S
authors.initials: RS
authors.lastname: Hoffman
mesh_terms: 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*
chemical_list: D001335:Vehicle Emissions; D008706:Methemoglobin; D008751:Methylene Blue