Cyanotic child - can it be Methaemoglobinemia?

Methaemoglobinemia is a rare condition and can give surprise in emergency setup. We have encountered one such case in emergency recently that presented with both peripheral and central cyanosis without cardio-respiratory compromise. The patient was confirmed to be suffering from methaemoglobinemia due to antimalarials that he had received before coming to the hospital. Cyanosis due to methaemoglobinemia in our patient was precipitated by concomitant glucose 6-phosphate dehydrogenase (G6PD) deficiency. The patient was managed with conservative management and vitamin C administration.