Methemoglobinemia Owing to Rectal-Probe Lubrication

Abstract

Methemoglobinemia is a cause of cyanosis in the absence of lung or cardiac disease. Nursery outbreaks owing to marking ink on diapers1and 3.25% triclocarban (3-4-41trichlorocarbanilide) in the diaper rinse2have been reported. Benzocaine has caused methemoglobinemia when given as a rectal suppository to infants and children,3-5when used as an endotracheal tube lubricant in an older child,6and when used topically on skin7-11or oral mucosa.12,13We wish to report another potential route of exposure. Report of a Case.—A 1,030-g female infant, was born at Tampa (Fla) General Hospital to a 19-year-old gravida 1 four days after spontaneous rupture of the membranes. The estimated gestational age was 27 weeks, and the mother had received two doses of betamethasone. Delivery was spontaneous, and the Apgar scores were 8 and 9, at 1 and 5 minutes of age, respectively. The initial gastric