# Acute G6PD deficiency haemolytic crises with associated methaemoglobinaemia in a patient with typhoid

## TL;DR

A man with G6PD deficiency experienced severe red blood cell damage and methaemoglobinaemia due to a typhoid infection, requiring careful treatment adjustments.

## Contribution

This case report highlights the rare occurrence of methaemoglobinaemia in G6PD deficiency triggered by typhoid and treatment challenges.

## Key findings

- G6PD deficiency combined with typhoid can cause haemolytic crises and methaemoglobinaemia.
- Methylene blue and high-dose ascorbic acid were contraindicated due to ongoing haemolysis and kidney issues.
- Heinz bodies and blister cells confirmed the diagnosis in blood smear analysis.

## Abstract

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked disorder that increases red blood cell susceptibility to oxidative damage. While haemolysis is common, methaemoglobinaemia is a rare complication. A 39-year-old man developed both conditions, triggered by Salmonella typhi infection. Diagnosis was supported by Heinz bodies and blister cells on blood smear. Methylene blue and high-dose ascorbic acid were relatively contraindicated because of ongoing haemolysis and renal dysfunction.

This case highlights the importance of considering methaemoglobinaemia in G6PD deficiency during infections and adapting treatment when standard therapies are unsuitable.