A non-fatal intoxication with a high-dose sodium nitrate

A 67-year-old man accidentally ingested 75 g of sodium nitrate. He had instant gastrointestinal symptoms. On physical examination, he was respiratorily and haemodynamically stable and there were no signs of central or peripheral cyanosis. Repeated methaemoglobin levels were normal and he made an uneventful recovery. Sodium nitrate intoxication is rare. Serious effects can occur, mainly through formation of nitrite and nitric oxide, which can cause methaemoglobinaemia and vasodilation. Even if the presenting symptoms are mild, it is important to remain cautious since more serious symptoms can occur later. Monitoring of respiratory and haemodynamic status and repeated blood gas analysis in order to detect methaemoglobinaemia are recommended.