Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2015; 3(10): 911-914
Published online Oct 16, 2015. doi: 10.12998/wjcc.v3.i10.911
Acute dapsone poisoning in a 3-year-old child: Case report with review of literature
Menon Narayanankutty Sunilkumar, Thekkuttuparambil Ananthanarayanan Ajith, Vadakut Krishnan Parvathy
Menon Narayanankutty Sunilkumar, Vadakut Krishnan Parvathy, Department of Paediatrics, Amala Institute of Medical Sciences, Amala Nagar, Thrissur 680555, Kerala, India
Thekkuttuparambil Ananthanarayanan Ajith, Department of Biochemistry, Amala Institute of Medical Sciences, Amala Nagar, Thrissur 680555, Kerala, India
Author contributions: Sunilkumar MN collected the clinical data and prepared the case report; Ajith TA had edited and critically revised the intellectual content; Parvathy VK approved the final version of the manuscript to be published.
Institutional review board statement: This case report was approved by the Institutional Ethics Committee, Amala Institute of Medical Sciences, Amala Nagar, Thrissur, Kerala, India.
Informed consent statement: The subject had given verbal consent for publishing this case report.
Conflict-of-interest statement: The authors declare that they have no conflicting interests including but not limited to commercial, personal, political, intellectual, or religious.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Menon Narayanankutty Sunilkumar, Associate Professor, Department of Paediatrics, Amala Institute of Medical Sciences, Amala Nagar, Thrissur 680555, Kerala, India. sunilsree99@gmail.com
Telephone: +91-487-2304116 Fax: +91-487-2307969
Received: May 15, 2015
Peer-review started: May 24, 2015
First decision: June 24, 2015
Revised: July 24, 2015
Accepted: August 13, 2015
Article in press: August 14, 2015
Published online: October 16, 2015
Processing time: 154 Days and 3 Hours
Abstract

Dapsone (DDS-diamino diphenyl sulphone) is a sulfone antibiotic being used for a variety of clinical conditions. Poisoning in children by DDS is rarely reported. Poisoning in acute cases will be frequently unrecognized due to relative lack of severe signs and symptoms. Methemoglobinemia is the major life-threatening situation associated with poisoning of DDS. Hence, any delay for medical attention can lead to increased rate of mortality. In this case, we describe acute DDS poisoning in a 3-year-old child and the successful management using intravenous methylene blue.

Keywords: Dapsone; Methemoglobinemia; Ascorbic acid; Methylene blue; Hemolysis

Core tip: Dapsone (DDS-diamino diphenyl sulphone), a sulfone antibiotic poisoning in children is rarely reported. Methemoglobinemia is the major life-threatening situation associated with DDS poisoning. Delay in seeking medical attention can lead to increased rate of mortality. Methylene blue 0.1% (2 mg/kg) as slow iv is the first line therapy. Furthermore, therapies like exchange transfusions and hyperbaric oxygen therapy are options especially in cases where contraindicated in glucose-6-phosphate dehydrogenase deficiency or if methylene blue therapy is ineffective.