FATAL METHEMOGLOBINEMIA DUE TO WELL WATER NITRATES

Abstract
The causes of acquired methemoglobinemia are reviewed and the metabolism of methemoglobin is briefly considered. Emphasis is placed upon methemoglobinemia related to ingestion of well water containing high levels of nitrates. The case history of a 20-day-old baby is presented. The baby died shortly after admission to the emergency room and history revealed that its feedings had been prepared from the water of a well having a nitrate content of 580 ppm. At autopsy, the blood contained 74% methemoglobin. Treatment of methemoglobinemia is briefly considered.

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