title: Methemoglobinemia secondary to topical silver nitrate therapy--a case report.
abstract: Methemoglobinemia is a rare complication in individuals exposed to nitrates or nitrites. Whereas methemoglobinemia is a recognized potential complication in burn patients treated with topical 0.5% silver nitrate solution, no report of methemoglobinemia in burn patients has been present in the literature for more than 15 years. We raise consciousness about this complication with a case report of a 12-month-old child with necrotizing fasciitis resulting from a cutaneous flank infection. The patient developed cyanosis 20 days after initiation of topical treatment with 0.5% silver nitrate solution. Intravenous injection of methylene blue can restore normal blood oxygenation.
authors.affiliation: Department of Surgery, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: T D
authors.initials: TD
authors.lastname: Chou
authors.forename: N S
authors.initials: NS
authors.lastname: Gibran
authors.forename: K
authors.initials: K
authors.lastname: Urdahl
authors.forename: E Y
authors.initials: EY
authors.lastname: Lin
authors.forename: D M
authors.initials: DM
authors.lastname: Heimbach
authors.forename: L H
authors.initials: LH
authors.lastname: Engrav
mesh_terms: D000287:Administration, Topical; D002053:Burn Units; D002056:Burns / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D019115:Fasciitis, Necrotizing / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008708:Methemoglobinemia / Q000139:chemically induced* / Q000188:drug therapy; D008751:Methylene Blue / Q000008:administration & dosage; D012835:Silver Nitrate / Q000008:administration & dosage / Q000009:adverse effects*; D016038:Skin Transplantation; D014946:Wound Infection / Q000150:complications / Q000188:drug therapy / Q000601:surgery
chemical_list: D012835:Silver Nitrate; D008751:Methylene Blue