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Cyanosis in Infants Caused by Nitrates in Well Water

Hunter H. Comly, M.D.
JAMA. 1987;257(20):2788-2792. doi:10.1001/jama.1987.03390200128027.
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Two examples of a previously unrecognized condition which may be confused with congenital heart disease are cited in this report. The condition may occur anywhere in rural areas where well water is used in infant feeding.


Case 1.—  C. H., a white female baby, was born two weeks before the expected date by cesarean section because of toxemia of pregnancy, which had been severe for one month. The birth weight was 3,870 Gm. (8 pounds 8 ounces). There was no known neonatal distress. On the twelfth day after birth, when she left the hospital, she weighed 3,720 grams (8 pounds 3 ounces). The formula she was receiving at that time was evaporated milk 210 cc. and water 540 cc. with 30 Gm. of a dextrin-maltose preparation.She was admitted to a local hospital at 18 days of age because of vomiting, excessive crying and failure to gain


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