A 41-year-old man presents to the emergency department with dyspnea, headache, vomiting, and weakness. He had a kidney transplant 9 years ago and has been on a stable antirejection regimen. He has allergies to ciprofloxacin and trimethoprim-sulfamethoxazole. Physical examination reveals gray-blue discoloration of the nose, fingers, and toes. Chest radiograph and electrocardiogram are unremarkable. Arterial blood gas analysis demonstrates a pH of 7.5, Po2 of 99 mm Hg, Pco2 of 18 mm Hg, bicarbonate level of 20.8 mmol/L, and oxygen saturation of 99%.
Which of the following medications is associated with this patient’s presentation?
Learn more about this case, take the quiz, and join the conversation on Figure 1
The Image of the Week for March 31 is brought to you in partnership with:
Submit your diagnosis to see full explanation.
Learn more about this case, and join the conversation on Figure 1.