RESUMEN
BACKGROUND: Potassium nitrate poisoning is a rare but potentially serious condition that can result in methemoglobinemia and subsequent cyanosis. This case report presents a unique instance of rapid-onset methemoglobinemia resulting from the ingestion of a traditional medicine preparation containing potassium nitrate, known as "kalmi shora." CASE PRESENTATION: A 14-year-old Pakistani boy reported to the emergency department with a history of sudden-onset headache, drowsiness agitation, irritability, and generalized cyanosis. Pulse oximetry showed a concerning oxygen saturation level of 58%, whereas arterial blood gas analysis revealed a normal partial pressure of oxygen (90 mmHg). The profile of abrupt onset of symptoms, generalized cyanosis, and the discrepancy between the partial pressure of oxygen and oxygen saturation readings necessitated a comprehensive assessment including inquiries into potential toxins. The peculiar appearance of the blood, resembling chocolate in color, further indicated the possibility of methemoglobinemia. The patient was successfully treated with methylene blue, leading to a prompt resolution of symptoms. CONCLUSION: This case highlights the significance of considering toxin exposures, such as traditional-medicine-induced poisoning, in emergency settings. The report contributes to the medical literature by highlighting the potential risks associated with traditional remedies and emphasizes the critical role of prompt diagnosis and intervention in optimizing patient outcomes. Recognition of the specific etiology of methemoglobinemia, in this case, traditional medicine ingestion, is essential for effective management in emergency medicine.
Asunto(s)
Metahemoglobinemia , Azul de Metileno , Humanos , Azul de Metileno/uso terapéutico , Metahemoglobinemia/inducido químicamente , Metahemoglobinemia/tratamiento farmacológico , Masculino , Adolescente , Nitratos/envenenamiento , Resultado del Tratamiento , Cianosis/inducido químicamenteRESUMEN
Carcinoid tumor of the testis represents only 0.23% of all testicular malignancies. We report the first case of bilateral asynchronous carcinoid tumor of the testis with a primary site in the small bowel. A 49-year-old man presented with several months of painless enlargement of the left testis. Orchiectomy revealed carcinoid tumor. The patient presented to the emergency room 2 weeks later and was found to have small bowel obstruction due to an ileal mass. The resected mass was the primary source of the carcinoid tumor. Four years later, examination revealed carcinoid tumor in his remaining testis.