Once in a blue moon: Primaquine-induced methemoglobinemia - A case report.
Respir Med Case Rep
; 38: 101675, 2022.
Article
en En
| MEDLINE
| ID: mdl-35651520
ABSTRACT
Methemoglobinemia is a rare blood disorder that should be suspected in patients with cyanosis and low oxygen saturation of around 85%, especially when both do not improve despite supplemental oxygen. We describe the case of a 67-year-old lung transplant patient who was treated with primaquine and clindamycin because of a positive Pneumocystis jirovecii polymerase chain reaction on bronchoalveolar lavage fluid. Soon thereafter the patient developed increasing shortness of breath, central cyanosis and hypoxia, with an oxygen saturation of 86% on pulse oximetry despite supplemental oxygen. Arterial blood gas analysis showed a peculiar dark brown color and a significantly increased methemoglobin percentage. A diagnosis of methemoglobinemia due to primaquine was made. As treatment option, we preferred ascorbic acid over methylene blue because of concerns of possibly eliciting a serotonin syndrome. Our patient recovered rapidly after initiation of appropriate treatment. A high index of suspicion is crucial since this condition is potentially fatal.
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1
Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Respir Med Case Rep
Año:
2022
Tipo del documento:
Article
País de afiliación:
Bélgica