title: An unusual complication of cocaine toxicity.
abstract: A 25-year man presented to the Accident and Emergency Department complaining of dizziness and shortness of breath after taking 70 grams of cocaine over 10 hours. He said a friend had noticed that his skin had turned dark blue. On examination the patient was severely centrally and peripherally cyanosed. His pulse oximeter oxygen saturations were 88% on air. An arterial blood gas showed a methaemoglobin level of 45.6%. The patient was diagnosed with cocaine-induced methaemoglobinaemia and given methyl thioninium chloride (methylene blue). He made an uneventful recovery.
authors.affiliation: Stoke Mandeville Hospital, Buckinghamshire, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Houghton
authors.forename: Quentin
authors.initials: Q
authors.lastname: Jones
authors.forename: Chris
authors.initials: C
authors.lastname: Wathen
mesh_terms: D000328:Adult; D003042:Cocaine / Q000097:blood / Q000506:poisoning*; D003490:Cyanosis / Q000097:blood / Q000139:chemically induced; D004244:Dizziness / Q000139:chemically induced; D004417:Dyspnea / Q000139:chemically induced; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008708:Methemoglobinemia / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy; D008751:Methylene Blue / Q000627:therapeutic use; D010092:Oximetry / Q000379:methods; D016896:Treatment Outcome
chemical_list: D004791:Enzyme Inhibitors; D003042:Cocaine; D008751:Methylene Blue