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Intravenous indoxacarb toxicity: A rare case of unusual exposure with clinical implications

Year: 2024

Type: article

Abstract: A 25-year-old male farmer presented to the emergency department with confusion, cyanosis, and low oxygen saturation (SpO₂) after an intentional intravenous injection of indoxacarb. Initial laboratory tests revealed severe methemoglobinemia (40.8 %), hypokalemia, hyponatremia, leukocytosis, and coagulation abnormalities. Despite supplemental oxygen, SpO₂ remained low, prompting Intensive Care Unit (ICU) admission. Methylene blue (2 mg/kg IV loading dose, followed by 1 mg/kg after one hour) was administered to reduce methemoglobin levels, which decreased to 2 % within six hours, leading to significant clinical improvement. By the second day, the patient's symptoms resolved, and SpO₂ stabilized at 96 % on room air. Following stabilization, he was transferred to the toxicology ward in good condition. This case highlights clinical presentation, management, and rapid recovery in an instance of intravenous indoxacarb poisoning.

Source: Toxicology Reports

DOI: 10.1016/j.toxrep.2024.101876

Authors: Hamidreza Farhadi Rad, Maryam Shahrokhi, Habibeh Mashayekhi-sardoo, Amir Amirkhani, Hamidreza Ghasemirad

Institutions: University of Jiroft, Jiroft University of Medical Sciences, Kerman University of Medical Sciences, Shahid Sadoughi University of Medical Sciences and Health Services

Language: English

Topic: Poisoning and overdose treatments

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,230