Dapsone (DDS-Diamino diphenyl sulfone), a sulfonamide derivative acts by inhibiting PABA incorporation into folic acid. It is commonly used in treating skin diseases. Accidental poisoning in children is uncommon. It results in methaemoglobinemia by causing oxidative stress. Principle of treatment relies on treating methemoglobinemia by using reducing agents like methylene blue or ascorbic acid. Due to the long half-life, dapsone provides a continuing oxidative stress that can cause a recurrence of clinically significant methaemoglobinaemia and hence takes long to treat. Ascorbic acid is effective in treating methemoglobinemia associated with dapsone poisoning as demonstrated in this case report of a four and half year old child's accidental ingestion of dapsone tablets and presenting with cyanosis. The child was managed successfully with ascorbic acid and supportive treatment.
A preterm, 26 6/7-week, 890-g male baby, was born to 39-year-old primigravida by vaginal delivery. She had preterm premature rupture of membranes at 25.6 weeks which led to severe oligohydramnios. Trial of continuation of pregnancy was attempted with amnioinfusion and continuous fetal monitoring. After 1 week trial, she went into preterm labour and delivered vaginally. Baby cried immediately after birth and received and covered in plastic bag, labour room continuous positive airway pressure was initiated and was shifted to neonatal intensive care unit for further management. He was initially started on non-invasive support and early rescue natural surfactant was given via INSURE (intubation, surfactant administration, extubation) method. In view of persistent high oxygen and increased work of breathing, the baby was intubated and started on mechanical ventilation. Umbilical vein was catheterised and tip was confirmed in inferior venae cavae. Post-natal sepsis screen was positive. On day 2 of life, the baby had clinical signs of haemodynamically significant patent ductus arteriosus (hs PDA), which was confirmed with twodimensional echocardiography, following which medical closure was carried out. At 50 h of life, the baby developed poor colour with increased ventilator requirement and chest X-ray (CXR) revealed rightsided pneumothorax (Fig. 1). An 22 G intravenous catheter was inserted in second intercostal space, however, that had to be
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.