Taylor, Gregory M.Avera, Robert S.Strachan, Christian C.Briggs, Christian M.Medler, Jason P.Pafford, Carl M.Gant, Timothy B.2022-05-262022-05-262021-02-15Taylor GM, Avera RS, Strachan CC, et al. Severe methemoglobinemia secondary to isobutyl nitrite toxicity: the case of the 'Gold Rush'. Oxf Med Case Reports. 2021;2021(2):omaa136. Published 2021 Feb 15. doi:10.1093/omcr/omaa136https://hdl.handle.net/1805/29153Isobutyl nitrite is one of the popular recreational drugs with high abuse potential that is known to cause methemoglobinemia. While inhaling this recreational drug, often referred to as a 'popper', is the typical route of administration, oral ingestion can produce a more rapid and fulminant course of methemoglobinemia. We present the case of a 69-year-old male that presented to our emergency department in extreme, life-threatening methemoglobinemia due to the ingestion of isobutyl nitrite that he obtained from an adult novelty store. The patient had a methemoglobin level above our lab cut-off of 28% and was subsequently treated with two doses of intravenous methylene blue. His hospital course was unremarkable, and he was discharged on Day 2. Methemoglobinemia is a medical emergency that requires a high index of clinical suspicion, prompt recognition, and rapid treatment.en-USPublisher PolicyAttribution 4.0 InternationalIsobutyl nitriteMethemoglobinemiaRecreational drugsArticle