Ingestion of isobutyl nitrite, a recreational chemical of abuse, causing fatal methemoglobinemia.

Isobutyl nitrite is widely abused as a sexual stimulant and enhancer of discotheque dancing. Though the usual route of administration by inhalation has not resulted in any toxicologically verified deaths, there may be fatal toxic methemoglobinemia if the chemical is orally ingested. A second case of death following ingestion is discussed.

Central nervous system ischemia after varicella infection and desmopressin therapy for enuresis.

A 7-year-old boy had a left-sided cerebrovascular accident 48 hours after beginning intranasal desmopressin acetate (DDAVP) therapy for persistent secondary nocturnal enuresis and approximately 2 weeks after varicella infection. A possible connection between desmopressin therapy or varicella infection (or both) and the patients neurologic symptoms is discussed, as is the relationship of desmopressin with hypercoagulability, Suggestions for patient/parent education, medical history taking, and patient surveillance are offered to prescribing physicians.