ArticleToxicology reports2025
Intravenous indoxacarb toxicity: A rare case of unusual exposure with clinical implications.
Article in Toxicology reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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