Methemoglobinemia (MetHb) is an uncommon and fatal condition. It is usually suspected when there is a discrepancy between the pulse oximetry reading and arterial blood gas analysis findings. Treatment depends on the level of MetHb and symptoms. Here, we present a case of an elderly male with lepromatous leprosy on regular therapy who developed influenza infection leading to the precipitation of erythema nodosum leprosum (ENL) and hypoxia due to drug-induced MetHb.
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