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Seizures and severe methaemoglobinaemia following accidental ingestion of amyl nitrite
  1. Patrick Timmons
  1. Infectious Disease/Internal Medicine, Queen Elizabeth University Hospital, Glasgow, UK
  1. Correspondence to Dr Patrick Timmons; patrick.timmons2{at}nhs.scot

Abstract

We present a case of a man in his late 40s presenting with generalised tonic-clonic seizures and profound methaemoglobinaemia shortly after inadvertent ingestion of amyl nitrite. Arterial blood gas analysis demonstrated methaemoglobin levels exceeding the upper detection threshold of our analyser, accompanied with profound cyanosis despite apparent oxygen saturations of 94%. Prompt administration of intravenous methylene blue led to a rapid and complete recovery. This case highlights the importance of swift recognition and treatment of methaemoglobinaemia particularly when the precipitating factor may be unknown at the time of presentation. This case also demonstrates the potential limitations of bedside blood gas analysers in diagnosis.

  • Poisoning
  • Toxicology
  • Emergency medicine

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Footnotes

  • Contributors PT was the clinician who cared for the patient, obtained patient consent for writing the case report and was the sole author of the manuscript.

  • Funding This study was funded by NHS Greater Glasgow and Clyde (421784).

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.