{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T15:58:30Z","timestamp":1757779110054,"version":"3.41.2"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":16,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This case report presents a patient with acquired methemoglobinemia due to unlabeled local anesthetic use. Some local anesthetics disrupt oxidative phosphorylation in erythrocytes, forming methemoglobin, which cannot transport oxygen. A 10-year-old boy with 60% total body surface area flame burns experienced sudden deterioration on Day 6 in the pediatric intensive care unit, presenting with cyanosis, tachycardia, hypotension, and SpO2 of 76% on room air, improving to 90% on 100% FiO2. A telemedicine consultation was requested, and evaluation revealed an elevated methemoglobin level of 22%. The source was an inadequately labeled ointment containing prilocaine used for burn wound care. This case underscores the importance of vigilant monitoring when using local anesthetics on pediatric burn patients. Additionally, global telemedicine played a crucial role in the timely diagnosis and management of this rare but life-threatening condition.<\/jats:p>","DOI":"10.1093\/jscr\/rjaf334","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T11:09:26Z","timestamp":1750072166000},"source":"Crossref","is-referenced-by-count":2,"title":["Unlabeled topical anesthetic-induced severe methemoglobinemia in a pediatric burn patient"],"prefix":"10.1093","volume":"2025","author":[{"given":"Christopher","family":"Mahir","sequence":"first","affiliation":[{"name":"UMass Chan Medical School , Department of Anesthesia and Perioperative Medicine, 55 N Lake Ave, Worcester, MA 01655 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Bean","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Anesthesia, Critical Care and Pain Medicine , 55 Fruit Street, Boston, MA 02114 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gennadiy","family":"Fuzaylov","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Anesthesia, Critical Care and Pain Medicine , 55 Fruit Street, Boston, MA 02114 ,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"2025061607092196600_ref1","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1007\/s11096-009-9294-z","article-title":"The quality of private pharmacy services in low and middle-income countries: a systematic review","volume":"31","author":"Smith","year":"2009","journal-title":"Pharmacy World & Science: PWS"},{"author":"Swayne","key":"2025061607092196600_ref2"},{"volume-title":"Medication Without Harm\u2014Global Patient Safety Challenge on Medication Safety","year":"2017","key":"2025061607092196600_ref3"},{"key":"2025061607092196600_ref4"},{"key":"2025061607092196600_ref5"},{"key":"2025061607092196600_ref6","doi-asserted-by":"publisher","first-page":"2179163","DOI":"10.1080\/16549716.2023.2179163","article-title":"Utilization of telehealth services in low- and middle-income countries amid the COVID-19 pandemic: a narrative summary","volume":"16","author":"Tiwari","year":"2023","journal-title":"Glob Health Action"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2025\/6\/rjaf334\/63498238\/rjaf334.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2025\/6\/rjaf334\/63498238\/rjaf334.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T11:09:26Z","timestamp":1750072166000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjaf334\/8163642"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,31]]},"references-count":6,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,5,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjaf334","relation":{},"ISSN":["2042-8812"],"issn-type":[{"type":"electronic","value":"2042-8812"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,5,31]]},"article-number":"rjaf334"}}