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. 2024 Sep 26;11(11):004837.
doi: 10.12890/2024_004837. eCollection 2024.

Life-Threatening Methaemoglobinaemia Secondary to Cetrimide

Radwan Zeidan  1 , Mohammed Abdallah  2 , Nazem Matta  3 , Patricia Nehme  4 , Mirna Fares  5
Affiliations

Life-Threatening Methaemoglobinaemia Secondary to Cetrimide

Radwan Zeidan et al. Eur J Case Rep Intern Med. .

Abstract

Methaemoglobinaemia is a rare but potentially life-threatening condition in which there is diminution of the oxygen-carrying capacity of the circulating haemoglobin. It can result from either congenital or acquired processes. Acquired methaemoglobinaemia is more prevalent than congenital methaemoglobinaemia, and notably it has a higher prevalence in infants and neonates than in adults; it results from exposure to oxidising agents. Methaemoglobin forms when haemoglobin is oxidised to contain iron in the ferric (Fe3+) state rather than the normal ferrous (Fe2+) state. Methaemoglobinaemia is a clinical diagnosis and is suspected in the presence of hypoxaemia refractory to supplemental oxygen and in the presence of chocolate-coloured blood. Symptoms are usually dependent on the methaemoglobin levels; at levels higher than 35%, systemic symptoms from tissue hypoxia may be fatal. We present a case of severe life-threatening methaemoglobinaemia following intra-abdominal use of cetrimide during hydatid cyst removal in a 60-year-old female.

Learning points: Cetrimide can cause methaemoglobinaemia when used as a protoscolicidal agent during the surgical treatment of hydatid cysts.Severe methaemoglobinaemia has high mortality rate and is usually missed and not easily diagnosed.

Keywords: Cetrimide; confusion; hypoxia; methaemoglobulinaemia; oxygen therapy.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
Chest X-ray showing clear lung fields with no pertinent abnormalities.
Figure 2
Figure 2
CT angiography showing A) bilateral pleural effusions with no evidence of pulmonary embolism; B) no signs of pulmonary embolism; C) no evidence of pericardial effusion.
Figure 3
Figure 3
CT angiography showing mild oedema surrounding the thyroid gland.
Figure 4
Figure 4
CT angiography showing diffuse abdominal oedema with no signs of bleeding.
See this image and copyright information in PMC

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