METHEMOGLOBINEMIA IN AN INFANT AS A RESULT OF THE ADMINISTRATION OF BISMUTH SUBNITRATE

Abstract

Despite occasional reports¹ of fatalities or near fatalities from the administration of bismuth subnitrate the drug is still commonly prescribed in the treatment of diarrheal disease in infants as well as older children and adults. The statement is made in Useful Drugs² under the section on bismuth compounds that "the salt most frequently used is bismuth subnitrate, but since this sometimes produces poisonous effects, the subcarbonate is preferable." The reduction of nitrate to nitrite by the intestinal flora, the absorption of the latter and the subsequent development of methemoglobinemia is supposed to be a recognized danger but a seldom considered sequence. The following case report is considered worthy of note to emphasize the possibly lethal effects of bismuth subnitrate and to reemphasize the method of treatment which may often be an emergency life saving measure. REPORT OF A CASE An infant aged 5 weeks and weighing 8½2 pounds