Near-fatal methemoglobinemia after recreational inhalation of amyl nitrite aerosolized with a compressed gas blower

J Formos Med Assoc. 2005 Nov;104(11):856-9.

Abstract

Adverse effects associated with recreational inhalation of nitrites are usually mild and rarely life-threatening. We report a rare case of near-fatal methemoglobinemia after inhalation of amyl nitrite after aerosolizing the liquid using a compressed gas blower designed to clean photographic equipment that employed hydrofluoroalkane-134a as a propellant. A 31-year-old previously healthy male became dyspneic and fainted soon after the recreational inhalation of amyl nitrite aerosolized using a compressed gas blower. He was brought to the emergency department with severe cyanotic appearance and profound shock. Oxygen saturation was 82%, unresponsive to oxygen supply. His methemoglobin blood level was 52.2%. After 100 mg of methylene blue (2 mg/kg body weight) was administered intravenously, he recovered consciousness, and dyspnea and cyanosis subsided gradually. This case illustrates the extraordinary hazard of the use of a compressed gas blower in the recreational inhalation of nitrites. Prompt recognition and rapid antidotal treatment may adequately correct near-fatal overdose associated with recreational use of amyl nitrite.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aerosols
  • Amyl Nitrite / poisoning*
  • Humans
  • Illicit Drugs / poisoning*
  • Male
  • Methemoglobinemia / chemically induced*
  • Methemoglobinemia / drug therapy
  • Methylene Blue / therapeutic use

Substances

  • Aerosols
  • Illicit Drugs
  • Amyl Nitrite
  • Methylene Blue