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Fatal Outcome of Methemoglobinemia in an Infant

Carl J. Johnson, MD; Pamela A. Bonrud, MS; Terrance L. Dosch; Arthur W. Kilness, MD; Kenneth A. Senger; Darron C. Busch; Michael R. Meyer, MS
JAMA. 1987;257(20):2796-2797. doi:10.1001/jama.1987.03390200136029.
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CASES of methemoglobinemia in infants and older members of farm families are probably more common than we realize. A 1950 report lists 144 cases of infant methemoglobinemia with 14 deaths in one 30-month period alone in Minnesota.1 In a 1982 survey of 353 physicians in the ten-county Big Sioux region in eastern South Dakota, 29 physicians reported having treated about 80 cases of methemoglobinemia, of which 64 had occurred more than ten years earlier.2 All but one case occurred in infants. This preventable, treatable intoxication continues to contribute to infant mortality today.

Report of a Case  A female infant born on April 30, 1986, was breast-fed at first and later received supplementary feedings with a powdered formula mixed with well water. The mother took her to the family physician for a one-month checkup on May 30. At that time, she looked quite healthy, although the mother reported blueness


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