A Rare Cause of Life-Threatening Hypoxemia in an Extreme Preterm: A Case Report
*Corresponding Author: Karthik Nagesh, Department of Neonatology, Manipal Hospital, Old Airport Road, Bangalore-560017, Karnataka, India, Email: drkarthiknagesh@gmail.comReceived Date: Sep 09, 2024 / Published Date: Feb 08, 2026
Citation: Devaranavadagi RA, Kannur NS, Reddy R, Nikitha K, Pejaver R, et al. (2026) A Rare Cause of Life-Threatening Hypoxemia in an Extreme Preterm: A Case Report. Neonat Pediatr Med 12: 613.DOI: 10.4172/2572-4983.1000613
Copyright: © 2026 Devaranavadagi RA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Neonatal Intensive Care Units (NICUs) often encounter the challenge of severe and persistent hypoxia. It is a worrisome problem, especially when the cause is not easy to determine. Carbapenems are extensively used antibiotics in the NICU, and their safety profile is well established. We report herewith a meropenem induced methemoglobinemia in an extreme preterm (24 week) weighing 555 grams at birth that caused persistent hypoxia on day 20 of life. After ruling out usual causes of hypoxia like cardiopulmonary, sepsis, a possibility of methemoglobinemia or abnormal hemoglobin was considered as the arterial blood gas showed relatively normal PAO2 though SPO2 was persistently low. Blood levels confirmed high methemoglobin levels (38.7%.) which confirmed the diagnosis of methemoglobinemia. Subsequently, the baby was treated with intravenous methylene blue and intravenous vitamin C. Hypoxia resolved with the above treatment, and repeat methemoglobin levels showed normal levels. The congenital cause of methemoglobinemia was unlikely, as the baby was well before and subsequently improved with treatment; hence, the other acquired causes were considered. The methemoglobinemia in our case could be due to intravenous meropenem (receiving for Burkholderia cepacia sepsis), as also reported by Andrade et al., which was later switched to Ceftazidime. This care report highlights the importance of deeply investigating the reason for abnormal findings rather than following a routine pattern of morbidity.
