Nitrite food poisoning from cold pork skin jelly: A report of two cases

Abstract

Rationale: Nitrite, a common meat preservative, can cause life-threatening methemoglobinemia. Patient’s concern: Two men (52 and 60 years) developed sudden cyanosis, dizziness, and nausea 10–20 minutes after consuming pork skin jelly from a local deli. Diagnosis: Acquired methemoglobinemia (methemoglobin 50.7% and 37.2%); jelly contained 420 mg/kg nitrite (GB 2760-2014 limit: 30 mg/kg). Interventions: High-flow oxygen and intravenous 1% methylene blue 1–2 mg/kg in 20 mL 5% glucose over 15 minutes. Outcomes: Cyanosis was relieved within 30 minutes; methemoglobin became normalized within 2 hours. Both recovered fully and were discharged on June 24, 2024. Lessons: Sudden cyanosis after meat consumption requires immediate hospitalization, methemoglobin testing, and methylene blue treatment; food residue analysis confirms diagnosis, while supplier monitoring and record-keeping prevent recurrence.

Keywords

Nitrite / Food poisoning / Pork rind jelly / Methemoglobinemia

Conflict of interest statement

The authors report no conflict of interest.

Ethical statement

This study was approved by the Institutional Review Board of Shandong University (approval number: IRB-SPH-SDU-20250371). All participants provided informed consent and participated voluntarily.

Data availability statement

The data supporting the findings of this study are available from the corresponding authors upon request.

Funding

This study received no extramural funding.

Authors’ contributions

LYR: data collection, manuscript drafting. ZQ & WGP: clinical data analysis. JXD case diagnosis and treatment. KBT: study design, manuscript review and editing.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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