@article{SUSARLA_CHINTALAPALLY_GUNDAPUNENI_PODISHETTI_2023, title={AN UNUSUAL CAUSE OF CYANOSIS}, volume={10}, url={https://pediatrics.medresearch.in/index.php/ijpr/article/view/740}, abstractNote={<p>t<br>Methaemoglobinemia is an uncommon haemoglobinopathy but potentially fatal if unrecognized or <br>untreated at the earliest. It can either be congenital or acquired. Acquired can be after using topical <br>anaesthetics such as nitrates, benzocaine, and lidocaine. The present study reports a rare case of <br>benzocaine induce Methaemoglobinemia. A 20 days old male baby presented to the emergency room <br>with complaints of seizure like activity in the past hour, bluish discoloration of skin since past 1 day and <br>loose watery stools since 3 days. Baby was irritable, crying with central cyanosis, had 2 episodes of <br>seizures upon arrival. He was tachypnoeic with saturations were 85% on room air along with <br>tachycardia. Perianal rash with excoriation of overlying skin was present. Rest of the examination was <br>unremarkable. He was managed with supplemental oxygen, IV antiepileptic and supportive treatment. <br>His septic screen was normal; Chest x-ray was unremarkable, 2D Echo showed a structurally normal <br>heart with normal biventricular function. His percutaneous oxygen saturation remained 85-88% despite <br>administration of 100% oxygen. His arterial blood sample had a dark chocolate color appearance, with <br>normal PaO2 levels on blood gases. His methaemoglobin levels were 21.7%. After, two doses of <br>methylene blue (1 mg/kg/dose) were administered, his cyanosis abated and oxygenation improved. <br>Repeat methaemoglobin levels were 1.3%. A relook into the history revealed use of Mucopaine gel for <br>perianal rash which contains Benzocaine confirming it as Benzocaine induced Methaemoglobinemia.</p&gt;}, number={2}, journal={Pediatric Review: International Journal of Pediatric Research}, author={SUSARLA, BALAJI and CHINTALAPALLY, SUMAN KUMAR and GUNDAPUNENI, RAVALI and PODISHETTI, SRAVYA}, year={2023}, month={Apr.}, pages={22-24} }