Methemoglobinemia: nitrobenzene ingestion

In an unusually severe case of multiple toxin ingestion, a 48-year-old man ingested approximately 300 cc of Hoppe's Gunpower Solvent #9, which contains kerosene, denatured ethyl alcohol, oil and nitrobenzene. The major manifestation was nitrobenzene-induced methemoglobinemia of rapid onset. Treatment involves the judicious use of 1% methylene blue plus, in severe cases, hemodynamic and ventilatory support. The patient recovered after 48 hours and was transferred to the psychiatric service with continued follow-up for a mild poison-induced hemolytic anemia.