Intravenous injection of India ink with suicidal intent

Abstract

We describe the case of a 33-year-old man who injected 4 ml of India ink into one of the median cubital veins with suicidal intent. He was hospitalized in good general condition 10 h after the injection. Abnormal laboratory test results were a leukocytosis, an oximetrically determined methemoglobin level of 36.9% (normal range: 1.5%) and a free hemoglobin level of 74 mumol/L (normal range: < 25 mumol/L). Toxicological examination showed the presence of nitrobenzene in blood and urine. Intravenous administration of vitamin C and tolonium chloride plus forced diuresis led to an improvement in cyanosis and a fall in the methemoglobin concentration. Repeated increase in the concentration of aminobenzene were successfully treated by hemodialysis with a high-flux dialyzer.

A case of fatal methemoglobinemia of unknown origin but presumably due to ingestion of nitrate

“…Nitrates and nitrites were identified and quantified using GC-MS and GC-NPD, respectively. This is a very rare case of intoxication such as intravenous injection of India ink into the vein [4] and accidental hydrogen sulfide poisoning [5]. Little is known of the underlying mechanism of this type of intoxication which could be important for the forensic toxicologist or emergency physician.…”