The Annals of pharmacotherapy
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Case Reports
Local cutaneous necrosis secondary to a prolonged peripheral infusion of methylene blue in vasodilatory shock.
To report a case of methylene blue extravasation and subsequent tissue necrosis in a patient with refractory septic shock. ⋯ To mitigate future risk to limb and skin, we recommend that methylene blue infusions be delivered via central venous catheter. Extra care should be given to patients with risk factors for extravasation, such as sedation, presence of systemic disease, proximal intravenous puncture sites, and improperly placed catheters.