This autopsy case documents a 10-month-old infant who died from compressive asphyxia following parental co-sleeping. Despite standard resuscitation and vasoactive support, rescue methylene blue administration failed to reverse refractory vasoplegic shock. Autopsy revealed distinctive bluish-green myocardial discoloration—the first pediatric autopsy documentation of methylene blue tissue staining—with no underlying structural cardiac pathology, suggesting the discoloration was a direct effect of the drug rather than disease.
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Autopsy-confirmed myocardial MB staining in an infant; reinforces awareness of tissue deposition when MB is used in pediatric refractory vasoplegia.