Fatal Methemoglobinemia Resulting from Ingestion of Isobutyl Nitrite, a “Room Odorizer” Widely Used for Recreational Purposes

The alkyl nitrites, specifically isobutyl nitrite, have taken a prominent place among those substances enjoying widespread recreational use, primarily in discotheques and during sexual activity. Though the usual route of administration by inhalation has not resulted in any toxicologically verified deaths, the chemical may cause fatal toxic methemoglobinemia if ingested. A case with a fatal outcome is presented, and the chemistry and toxicology of the substance are discussed.