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Methemoglobinemia: nitrobenzene ingestion.
M A Schimelman1, J M Soler, H A Muller
1Emergency Medicine Division, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
JACEP
|November 1, 1978
Summary
A severe case of multiple toxin ingestion led to rapid-onset nitrobenzene-induced methemoglobinemia. Treatment with methylene blue and supportive care resulted in patient recovery from this poisoning.
Area of Science:
- Toxicology
- Emergency Medicine
- Environmental Health
Background:
- Multiple toxin ingestion is a critical medical emergency.
- Nitrobenzene is a component found in some industrial solvents and cleaning agents.
Observation:
- A 48-year-old male ingested approximately 300 cc of Hoppe's Gunpower Solvent #9.
- The solvent contained kerosene, denatured ethyl alcohol, oil, and nitrobenzene.
- The primary clinical manifestation was rapid-onset methemoglobinemia induced by nitrobenzene.
Findings:
- The patient presented with severe nitrobenzene-induced methemoglobinemia.
- Treatment included 1% methylene blue and, in severe instances, hemodynamic and ventilatory support.
- The patient recovered within 48 hours, with follow-up for mild hemolytic anemia.
Implications:
- Prompt recognition and treatment of nitrobenzene poisoning are crucial.
- Methylene blue is an effective antidote for methemoglobinemia.
- Severe poisonings necessitate comprehensive medical and psychiatric follow-up.