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Critical Rebound Methemoglobinemia After Methylene Blue Treatment: Case Report
Author(s) -
Fitzsimons Michael G.,
Gaudette Ronald R.,
Hurford William E.
Publication year - 2004
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.24.5.538.33356
Subject(s) - methemoglobinemia , methylene blue , medicine , methylene , anesthesia , chemistry , medicinal chemistry , organic chemistry , photocatalysis , catalysis
A 39‐year‐old man developed significant methemoglobinemia after receiving benzocaine spray; he was treated appropriately with intravenous methylene blue. The patient's methemoglobin levels decreased, but this was followed by a critical rebound phenomenon to levels frequently considered near fatal. After further treatment with methylene blue, the patient's methemoglobin levels returned to normal. Clinicians need to be aware that a decreasing level of methemoglobin does not necessarily indicate that a crisis has passed and that further monitoring and treatment may be indicated.