FATAL AND RECURRENT METHEMOGLOBINEMIA AFTER INGESTION OF PRINTING REDUCER DYE (NITROBENZENE)
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2013, Vol 2, Issue 10
Abstract
Nitrobenzene, a pale yellow oily liquid with an odour of bitter almonds is used as intermediate in the synthesis of aniline dyes, and as a solvent for the manufacture of cellulose ethers and acetate, as a flavouring agent and in rubber industry. Nitrobenzene induces methemoglobinemia and this is responsible for the manifestations. It is important to take care of the secondary cycling of nitrobenzene from body stores in patients presenting late, after heavy exposure. Clues for diagnosis are a history of chemical ingestion. The characteristic smell of almonds, central cyanosis with no apparent respiratory distress, low pulse oximeter (observed) oxygen saturation with normal ABG (calculated) oxygen saturation and persisting cyanosis on oxygen therapy, without severe cardiopulmonary disease. Dark brown blood that fails to turn bright red on shaking suggests methemoglobinemia and this is supported by chocolate red colour of dried blood. To manage chemically induced methemoglobinemia properly, a clinician must be aware of its pathophysiology, be skilled with the use of reducing agents such as methylene blue, and understand specific physiochemical properties of the toxin. Acute poisoning with nitrobenzene is presented where clinical evaluation and timely management, with repeated intravenous methylene blue helped to save a life.
Authors and Affiliations
Shahid Abbas, Himanshu Dagor, Piyush Manoria, Rohit Ved, Riaz Hussain
Keywords
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- DOI 10.14260/jemds/405
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