A Case Report of Acute Transient Encephalopathy Following a Trans-esophageal Echocardiography

Mir, Wasey Ali Yadullahi; Shrestha, Dhan Bahadur; Reddy, Vijay Ketan; Gaire, Suman; Verda, Larissa

doi:10.7759/cureus.18580

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…[ 10 ] presented a case of methemoglobinemia and acute hemolysis induced by tetracaine lozenges. Several studies reported methemoglobinemia induced by inhalation of anesthetics [ 11 , 12 ]. Methemoglobinemia is diagnosed by pulse oximetry, patient symptoms, and ABG with CO-oximetry [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Hemolysis and acquired methemoglobinemia associated with lidocaine and benzocaine topical application: a case report

2023

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Background Topical anesthetics are commonly used over the counter, and one of the adverse effects of these medications is methemoglobinemia, which is a serious and life-threatening condition. Case presentation We describe a 25-year-old Persian male presenting with generalized weakness, dizziness, headache, and cyanosis. In addition, he had genital warts starting 3 weeks ago, which were self-treated with podophyllin, resulting in itching and pain. He used over-the-counter topical anesthetics, including benzocaine and lidocaine, to reduce the symptoms. According to the lab data, signs and symptoms of methemoglobinemia and hemolysis were diagnosed. Considering the hemolysis, ascorbic acid was used for treatment. The patient was discharged after 5 days with normal arterial blood gas and pulse oximetry and no signs and symptoms. Conclusion This case highlights that self-administration of some topical anesthetics may lead to potentially fatal conditions.

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Section: Discussionmentioning

confidence: 99%

Hemolysis and acquired methemoglobinemia associated with lidocaine and benzocaine topical application: a case report

2023

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“…For the cases presented, diagnosis of sodium nitrite toxicity was based on a wide variety of information obtained from the decedent history, death scene, autopsy, toxicology, and biochemistry findings, often in the absence of a definitive, quantitative diagnostic test. While there are several other possible causes of methemoglobinemia, both congenital and acquired (including recessive congenital methemoglobinemia [43], mothball intoxication [44] and dapsone overdose [45], and several other substances [46]), all death investigations demonstrated evidence of sodium nitrite ingestion. Furthermore, use of the urinalysis dipstick for presumptive nitrite detection was applied in the latter eight cases, which all returned a positive result, raising suspicion of potential sodium nitrite toxicity and prompted further investigations.…”

Section: Discussionmentioning

confidence: 99%

Increasing use of sodium nitrite in suicides—an emerging trend

Stephenson

Wills

Heuvel

et al. 2022

Forensic Sci Med Pathol

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Sodium nitrite (NaNO2) is a compound with broad practical applications in food preservation, automotive maintenance, and animal control. Sodium nitrite is also potentially fatal when ingested, as it interferes with the ability of red blood cells to transport oxygen. While incidents of accidental consumption have been reported in the literature, case reports of sodium nitrite being used as a pharmacological suicide agent are becoming more frequent. Therefore, a study was undertaken to evaluate trends in sodium nitrite deaths in South Australia between 2000 and 2019. All cases of fatal sodium nitrite ingestion were identified in the Toxicology database and autopsy reports at Forensic Science SA (FSSA). Ten cases of fatal sodium nitrite ingestion were identified, with the rate of cases increasing significantly over the study period (p > .001). Of the ten deaths attributed to sodium nitrite toxicity, eight were male, and two were female. The age range of decedents was 22–74 years (mean 51.9, SD 21.1), 22–74 years for males (mean 58.4, SD 18.2) and 23–29 years for females (mean 26.0, SD 4.2). Males (80%) and those with a history of depression and/or suicidal ideation (70%) were over-represented within the study population. While autopsy findings were generally consistent with the literature, scene findings emphasized the accessibility of sodium nitrite to the general public. This study highlights both a significant increasing trend in the use of sodium nitrite in suicides and important analytical limitations in the evaluation of suspected cases.

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Bellastesin-Associated Methemoglobinemia in a Patient with Liver Alveococcosis

Artamonova

Фомин

2022

Vestn. anesteziol. reanimatol.

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The presented clinical observation and analysis of the literature data draws an attention on the possibility of developing a life-threatening condition such as methemoglobinemia due to the use of the benzocaine preparation. The latter is part of the preparation bellastesin for the treatment of gastroenterological diseases. This drug is often taken by patients at their own at discretion and with no proper control and consideration of existing co-morbidities. In addition, one needs to pay attention on the indicators of oximetry, including the level of methemoglobin, when diagnosing diseases accompanied by cyanosis and respiratory insufficiency.

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A Case Report of Acute Transient Encephalopathy Following a Trans-esophageal Echocardiography

Cited by 3 publications

References 11 publications

Hemolysis and acquired methemoglobinemia associated with lidocaine and benzocaine topical application: a case report

Hemolysis and acquired methemoglobinemia associated with lidocaine and benzocaine topical application: a case report

Increasing use of sodium nitrite in suicides—an emerging trend

Bellastesin-Associated Methemoglobinemia in a Patient with Liver Alveococcosis

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