The purpose of this communication is to review the subject of methemoglobinemia in infancy and to add a report of a case of methemoglobinemia in neonatal life, resulting from the ingestion of well water containing large amounts of nitrates.
Methemoglobinemia has been recognized as a disease entity for many years. Several authors have grouped the cases according to the chemical responsible for the disturbance, such as aniline dyes (wax crayons), bismuth subnitrate, potassium chlorate, nitrites, acetanilid and sulfonamide compounds. Methemoglobinemia has also been reported to occur in the following clinical syndromes: congenital or idiopathic methemoglobinemia,1 Winckel's disease2 and enterogenous cyanosis.3
Interest in methemoglobinemia, as it occurs in infants, is only of recent date. In 1945, Comly4 reported 2 cases of methemoglobinemia in early life and mentioned 19 others. He proposed that the high nitrate and nitrite content of well water used as a diluent for the