Acquired methemoglobinemia is a dyshaemoglobinemia which results from exposure to various oxidizing agents, results in impaired oxygen delivery to the tissues and can be potentially fatal if untreated. Deliberate ingestion of certain herbicides, insecticides, and pesticides may produce this condition. We report 2 cases of methemoglobinemia due to intentional ingestion of pesticides which were marketed to be safe and contain only biological extracts and fillers. Methylene blue, ascorbic acid, blood transfusion and exchange transfusion are the various modalities of treatment.
Meningoencephalitis is an inflammation of the brain and its surrounding protective membranes. Meningitis is a life-threatening disease and can lead to significant sequelae. We were presented with a 6 year 5 months old female child on ventilation, retrieved by referral hospital on examination revealed human herpesvirus 6 through cerebrospinal fluid analysis and diagnosed with meningoencephalitis on Magnetic Resonance Imaging(MRI) with three repeated failed extubation and hence planned tracheostomy. Child presented no movements with suspected motor or sensory (vision, hearing) disability, generalized tonic-clonic seizure (GTCS), altered sensorium requiring a long term rehabilitation and nutrition support. On close monitoring, a continuous effort of three months and with a multidisciplinary clinical approach from different disciplines including neurologist, intensivist, clinical dietitian and physiotherapy, the child successfully completed the long term rehabilitation treatment with remarkable improvement observed within 12 weeks both neurologically and nutritionally with a better clinical outcome.
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