{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:22:19Z","timestamp":1768342939462,"version":"3.49.0"},"reference-count":17,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,12,23]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    A previously healthy female was admitted following inpatient antibiotic treatment for a lower respiratory tract infection. Since admission, her pulse oximetry revealed low oxygen saturation despite oxygen supplementation. The oxygen pressure in arterial blood remained normal with a wide gap between peripheral oxygen saturation and arterial oxygen saturation values. Suspicion of methaemoglobinaemia was raised. Methaemoglobinaemia reduction test (Brewer\u2019s test) became positive and was confirmed with a blood methaemoglobin assay value of 18.19%. High-performance liquid chromatography excluded the presence of haemoglobin-M. She was treated with intravenous antibiotics with careful monitoring of methaemoglobin levels but without the need for methylene blue administration. Serology to detect antibodies against\n                    <jats:italic>Mycoplasma pneumoniae<\/jats:italic>\n                    was initially negative, but suspicion for\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    infection was high and treatment was continued. Convalescent serum total anti-\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    antibody levels rose from 1:40 at 11 days to 1:1280 at 16 days confirming the diagnosis of\n                    <jats:italic>M. pneumoniae<\/jats:italic>\n                    pneumonia.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-268289","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:47:41Z","timestamp":1768319261000},"page":"e268289","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Methaemoglobinaemia as a rare complication of\n                    <i>Mycoplasma pneumoniae<\/i>\n                    pneumonia"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8839-0084","authenticated-orcid":false,"given":"Kasun Anuradha","family":"Nanayakkara","sequence":"first","affiliation":[{"name":"Internal Medicine, Sri Jayewardenepura General Hospital, Nugegoda, Western Province, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subasinghe Arachchige Shyama Padmak","family":"Subasinghe","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sri Jayewardenepura General Hospital, Nugegoda, Western Province, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weerasinghe Mudiyanselage Ishara Na","family":"Weerasinghe","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sri Jayewardenepura General Hospital, Nugegoda, Western Province, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5663-5177","authenticated-orcid":false,"given":"Hiruni","family":"Amanda","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sri Jayewardenepura General Hospital, Nugegoda, Western Province, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"2026011307351506000_19.1.e268289.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(99)70167-8"},{"key":"2026011307351506000_19.1.e268289.2","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1002\/ajh.26340","article-title":"Recommendations for diagnosis and treatment of methemoglobinemia","volume":"96","author":"Iolascon","year":"2021","journal-title":"American J Hematol"},{"key":"2026011307351506000_19.1.e268289.3","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2147\/JBM.S468072","article-title":"Management of Congenital Methemoglobinemia in the Perioperative Setting: A Case Report and Review of Current Literature","volume":"15","author":"Saad","year":"2024","journal-title":"J Blood Med"},{"key":"2026011307351506000_19.1.e268289.4","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jclinane.2003.10.005","article-title":"Anesthetic management of a patient with congenital methemoglobinemia","volume":"16","author":"Maurtua","year":"2004","journal-title":"J Clin Anesth"},{"key":"2026011307351506000_19.1.e268289.5","doi-asserted-by":"crossref","DOI":"10.1186\/s40748-022-00142-0","article-title":"Case report of congenital methemoglobinemia: an uncommon cause of neonatal cyanosis","volume":"8","author":"Lyle","year":"2022","journal-title":"Matern Health Neonatol Perinatol"},{"key":"2026011307351506000_19.1.e268289.6","doi-asserted-by":"publisher","DOI":"10.1097\/01.md.0000141096.00377.3f"},{"key":"2026011307351506000_19.1.e268289.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2013.02.004"},{"key":"2026011307351506000_19.1.e268289.8","doi-asserted-by":"crossref","DOI":"10.1186\/s13054-015-0984-8","article-title":"Pulse oximetry","volume":"19","author":"Jubran","year":"2015","journal-title":"Crit Care"},{"key":"2026011307351506000_19.1.e268289.9","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/MJT.0000000000000028","article-title":"Ascorbic acid for the treatment of methemoglobinemia: the experience of a large tertiary care pediatric hospital","volume":"21","author":"Rino","year":"2014","journal-title":"Am J Ther"},{"key":"2026011307351506000_19.1.e268289.10","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2013.02.005"},{"key":"2026011307351506000_19.1.e268289.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(96)70112-9"},{"key":"2026011307351506000_19.1.e268289.12","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2022.20949","article-title":"Global Trends in the Proportion of Macrolide-Resistant Mycoplasma pneumoniae Infections: A Systematic Review and Meta-analysis","volume":"5","author":"Kim","year":"2022","journal-title":"JAMA Netw Open"},{"key":"2026011307351506000_19.1.e268289.13","unstructured":"Murray PR , Rosenthal KS , Pfaller MA . Medical microbiology. 9th edn. Philadelphia, PA: Elsevier, 2021."},{"key":"2026011307351506000_19.1.e268289.14","unstructured":"Sri Lanka College of Microbiologists . Empirical and prophylactic use of antimicrobials \u2013 national guidelines \u2013 Sri Lanka. 2nd edn. Colombo (Sri Lanka): Sri Lanka College of Microbiologists, 2024."},{"key":"2026011307351506000_19.1.e268289.15","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofv022","article-title":"Mycoplasma pneumoniae Pneumonia Associated With Methemoglobinemia and Anemia: An Overlooked Association?","volume":"2","author":"Khoury","year":"2015","journal-title":"Open Forum Infect Dis"},{"key":"2026011307351506000_19.1.e268289.16","doi-asserted-by":"publisher","DOI":"10.1128\/IAI.68.11.6419-6422.2000"},{"key":"2026011307351506000_19.1.e268289.17","doi-asserted-by":"publisher","DOI":"10.1038\/210963a0"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268289","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:47:43Z","timestamp":1768319263000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,13]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bcr-2025-268289"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268289","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}