Methemoglobinemia After Transesophageal Echocardiogram

The widespread administration of local anesthetics such as benzocaine necessitates understanding their lesser-known adverse effects. Acquired methemoglobinemia (MetHb) is a rare but life-threatening complication associated with the routine use of benzocaine spray prior to endoscopic procedures such as transesophageal echocardiography (TEE). Recognizing the manifestation of MetHb is critical to early detection and appropriate management of this condition. We present a case of MetHb in a patient with sepsis and anemia, resulting in respiratory failure, and offer an overview of the existing literature on the subject.