{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T22:44:31Z","timestamp":1778798671163,"version":"3.51.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T00:00:00Z","timestamp":1649030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Delayed post-hypoxic leukoencephalopathy (DPHL) is a demyelinating syndrome that occurs days to weeks after the brain has recovered from a coma. It is caused by the period of hypoxia and is characterized by mental disorders, extrapyramidal system symptoms, and motor changes. Common causes include cardiogenic shock, severe anemia, massive blood loss, and poisoning. Poisoning, mostly resulting from intoxication with carbon monoxide and several narcotic drugs, has been reported to be a cause of DPHL. There are only a few reports of DPHL due to nitrite poisoning in literature. We report DPHL in a patient following nitrite poisoning and a review of the literature in this context.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Presentation<\/jats:title><jats:p>A 64-year-old man presented with dizziness and nausea without vomiting. He later went into a coma after consuming a spare rib soup. After blood gas analysis, we suspected nitrite poisoning combined with metabolic acidosis, hypoxemia, and electrolyte imbalance. He gradually showed neurologic recovery to premorbid baseline after intravenous administration of methylene blue (40 mg) and symptomatic treatment. Two months later, the patient's cerebral magnetic resonance imaging (MRI) showed signs that are compatible with injury, with the patient in late stages of mental decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Nitrite poisoning can cause DPHL. There is a period of intermittent recovery between the time of poisoning and the development of DPHL, but the specific pathogenesis and treatment are still unclear.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.836844","type":"journal-article","created":{"date-parts":[[2022,4,4]],"date-time":"2022-04-04T05:30:12Z","timestamp":1649050212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Delayed Post-Hypoxic Leukoencephalopathy Following Nitrite Poisoning: A Case Report and Review of the Literature"],"prefix":"10.3389","volume":"13","author":[{"given":"Yankun","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiumei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingling","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianli","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1007\/s12024-018-0036-1","article-title":"Sodium nitrite food poisoning in one family","volume":"15","author":"Cvetkovi\u0107","year":"2019","journal-title":"Forensic Sci Med Pathol."},{"key":"B2","volume-title":"Sausage and ready to serve meats","year":"1938"},{"key":"B3","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1016\/j.meatsci.2011.05.018","article-title":"Incubation of curing brines for the production of ready-to-eat, uncured, no-nitrite-or-nitrate-added, ground, cooked and sliced ham","volume":"89","author":"Krause","year":"2011","journal-title":"Meat Sci."},{"key":"B4","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/S0196-0644(99)70167-8","article-title":"Methemoglobinemia: etiology, pharmacology, and clinical management","volume":"34","author":"Wright","year":"1999","journal-title":"Ann Emerg Med."},{"key":"B5","first-page":"134","article-title":"The classification and treatment of methemoglobinemia","volume":"27","author":"Doctor","year":"1953","journal-title":"Q Bull Northwest Univ Med Sch."},{"key":"B6","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1056\/NEJM200108093450606","article-title":"Toxic leukoencephalopathy","volume":"345","author":"Filley","year":"2001","journal-title":"N Engl J Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"67","DOI":"10.23907\/2012.009","article-title":"Chasing the dragon: a review of toxic leukoencephalopathy","volume":"2","author":"Krinsky","year":"2012","journal-title":"Acad Forensic Pathol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"761","DOI":"10.1007\/s00280-008-0876-6","article-title":"Central and peripheral nervous system toxicity of common chemotherapeutic agents","volume":"63","author":"Sioka","year":"2009","journal-title":"Cancer Chemother Pharmacol."},{"key":"B9","first-page":"1592","article-title":"Delayed encephalopathy of acute carbon monoxide intoxication: diffusivity of cerebral white matter lesions","volume":"24","author":"Kim","year":"2003","journal-title":"AJNR Am J Neuroradiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e00364","DOI":"10.1002\/brb3.364","article-title":"Delayed posthypoxic leukoencephalopathy: a case series and review of the literature","volume":"5","author":"Zamora","year":"2015","journal-title":"Brain Behav."},{"key":"B11","first-page":"198","article-title":"Reversible delayed leukoencephalopathy after heroin intoxication with hypoxia:a case report","volume":"18","author":"Chang","year":"2009","journal-title":"Acta Neurol Taiwan."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1212\/WNL.49.5.1400","article-title":"Delayed posthypoxic demyelination. 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