A 5-Month-Old Infant with Diffuse Cyanosis and No Other Symptoms

Saccomani, Marco Deganello; Cavarzere, Paolo; Silvagni, Davide; Corso, Sara Dal; Perlini, Silvia; Biban, Paolo

doi:10.3928/00904481-20160303-01

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…The content of leaves from leafy vegetables must be limited, and multiple administrations during the day must be avoided. It has been suggested that no more than 5-10 leaves of leafy vegetables such as chards and spinach should be included [16]. Moreover, the consumption of vegetable soups must occur immediately after preparation.…”

Section: Discussionmentioning

confidence: 99%

The Dose Makes the Poison: A Case Report of Acquired Methemoglobinemia

Cannata

Abate

Scarabello

et al. 2020

IJERPH

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Background: Methemoglobinemia (MET) should be suspected in cases where cyanosis is not associated with signs and symptoms of lung and/or heart disease, or in a cyanotic child exhibiting discrepancies in the partial pressure of oxygen in the arterial blood, the blood oxygen saturation, and the clinical assessment. Case presentation: A 10-month-old girl was taken to the Pediatric Emergency Department for the acute, sudden development of significant peroral cyanosis associated with gray pigmentation of the skin. The problem was evidenced approximately one hour after she ingested a homemade puree of mixed vegetables, mainly composed of potatoes and chards that had been prepared three days before and had been kept in the refrigerator since then. Physical examination revealed that the child was very pale, conscious, and without respiratory distress. Oxygen saturation of hemoglobin in the arterial blood (SpO2) was 94%. Respiratory, cardiovascular, and abdominal evaluations did not reveal any signs of disease. A venous blood sample showed chocolate-colored blood with a pH of 7.404, a partial pressure of CO2 (pCO2) of 40.6 mmHg, a partial pressure of oxygen (pO2) of 21.3 mmHg, a bicarbonate level of 24 mmol/L, and an oxygen saturation (SO2%) of 47.7%. CO-oximetry carried out simultaneously identified a methemoglobin level of 22%. MET was suspected, and oxygen via nasal cannula at a rate of 4 L/min was given with only a slight increase in oxygen saturation (96%). Slow intravenous injection of methylene blue 1 mg/kg over a period of 5 min was initiated. The peripheral oxygen saturation (SpO2) gradually improved to 100% over the next 20 min. Forty minutes later, venous blood gas analysis showed a methemoglobin level of 0.9% with a complete resolution of cyanosis; supplemental oxygen via nasal cannula was therefore discontinued. During the next 36 h, the patient remained hemodynamically stable with good oxygenation on room air. Conclusions: This case report shows that recognition of acquired MET in a child with sudden cyanosis onset requires a high index of suspicion. In daily activities, there is a need to pay particular attention when homemade vegetable soups for child alimentation are prepared. The consumption of vegetable soups must occur immediately after preparation. Storage in a refrigerator must last no more than 24 h and if longer storage is needed, vegetable soups should be frozen.

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Section: Discussionmentioning

confidence: 99%

The Dose Makes the Poison: A Case Report of Acquired Methemoglobinemia

Cannata

Abate

Scarabello

et al. 2020

IJERPH

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Foreword: Methemoglobinemia: Infants at Risk

Etzel¹

2019

Current Problems in Pediatric and Adolescent Health Care

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Nitrites: An Old Poison or a Current Hazard? Epidemiology of Intoxications Covering the Last 100 Years and Evaluation of Analytical Methods

Tusiewicz,

Kuropka,

Workiewicz

et al. 2023

Toxics

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In recent times, there has been a concerning and noteworthy rise in the global use of sodium nitrite for suicidal purposes. This is facilitated either through the employment of specialized “suicide kits” or by acquiring sodium nitrite through alternative means. Additionally, another occurrence contributing to nitrite poisoning is the recreational utilization of nitrites in the form of volatile aliphatic esters of nitrous acid, commonly referred to as “poppers”. Based on current available papers and reports on the subject of nitrates, nitrites, and poppers intoxications, an epidemiological analysis and evaluation of analytical methods were performed. A total of 128 papers, documenting a collective count of 492 intoxication cases, were identified. Additionally, in order to complete the epidemiological profile of nitrite poisoning, the authors briefly examined six cases of nitrite intoxication that were under investigation in our laboratory. Furthermore, a review of nitrite poisoning cases over the past 100 years shows that the old poison is still in use and poses a substantial risk to society.

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A 5-Month-Old Infant with Diffuse Cyanosis and No Other Symptoms

Cited by 3 publications

References 17 publications

The Dose Makes the Poison: A Case Report of Acquired Methemoglobinemia

The Dose Makes the Poison: A Case Report of Acquired Methemoglobinemia

Foreword: Methemoglobinemia: Infants at Risk

Nitrites: An Old Poison or a Current Hazard? Epidemiology of Intoxications Covering the Last 100 Years and Evaluation of Analytical Methods

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