Methemoglobinemia physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]; Associate Editor(s)-in-Chief: Aksiniya Stevasarova, M.D.

Overview

Patients with methemoglobinemia usually present with gray or bluish skin discoloraion. Physical examination of patients with methemoglobinemia is usually remarkable for headache, tachycardia, dyspnea and lightheadedness.

Physical Examination

Appearance of the Patient Methemoglobinemia patients can present with different shades of bluish skin color, depending on the levels of MetHb in the blood. ^[1]

Vital Signs

Tachycardia with regular pulse

Respiratory depression

Dyspnea

Cyanosis ^[2]

General Physical Examination

Blue-colored skin, lips, and nail beds

Pallor

Lightheadedness

Headache

Cyanosis

Lethargy

Altered mental status in higher MetHb levels

Coma

Shock

Seizures^[3]

References

↑ Chung NY, Batra R, Itzkevitch M, Boruchov D, Baldauf M (2010). “Severe methemoglobinemia linked to gel-type topical benzocaine use: a case report”. J Emerg Med. 38 (5): 601–6. doi:10.1016/j.jemermed.2008.06.025. PMID 19097728.
↑ Orlandi M, Amadi MA, Goldaracena PX, Péreza FE (2018). “[Cyanosis in 14-year-old patient. Methemoglobinemia: case report]”. Arch Argent Pediatr. 116 (3): e429–e432. doi:10.5546/aap.2018.e429. PMID 29756717.
↑ Cho YS, Chung BY, Park CW, Kim HO (2016). “Seizures and Methemoglobinemia After Topical Application of Eutectic Mixture of Lidocaine and Prilocaine on a 3.5-Year-Old Child with Molluscum Contagiosum and Atopic Dermatitis”. Pediatr Dermatol. 33 (5): e284–5. doi:10.1111/pde.12927. PMID 27397059.

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[pmid19097728-1] Chung NY, Batra R, Itzkevitch M, Boruchov D, Baldauf M (2010). “Severe methemoglobinemia linked to gel-type topical benzocaine use: a case report”. J Emerg Med. 38 (5): 601–6. doi:10.1016/j.jemermed.2008.06.025. PMID 19097728.

[pmid29756717-2] Orlandi M, Amadi MA, Goldaracena PX, Péreza FE (2018). “[Cyanosis in 14-year-old patient. Methemoglobinemia: case report]”. Arch Argent Pediatr. 116 (3): e429–e432. doi:10.5546/aap.2018.e429. PMID 29756717.

[pmid27397059-3] Cho YS, Chung BY, Park CW, Kim HO (2016). “Seizures and Methemoglobinemia After Topical Application of Eutectic Mixture of Lidocaine and Prilocaine on a 3.5-Year-Old Child with Molluscum Contagiosum and Atopic Dermatitis”. Pediatr Dermatol. 33 (5): e284–5. doi:10.1111/pde.12927. PMID 27397059.

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