Life threatening rebound methemoglobinemia following paint ingestion

Abstract

A 4-year-girl presented with cyanosis and altered sensorium after ingestion of paint. She was diagnosed to be having methemoglobinemia and treated appropriately with methylene blue. She responded to treatment but again deteriorated the next day for which a repeat dose of methylene blue was needed. One should be aware about rebound methemoglobinemia and the need for further monitoring and treatment.