Indian Journal of Critical Care Case Report

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VOLUME 2 , ISSUE 1 ( January-February, 2023 ) > List of Articles


Indoxacarb Toxicity: Treat the Patient, Not the Monitor

Sangam Yadav

Keywords : High-flow oxygen, Indoxacarb, Methemoglobinemia, Methylene blue

Citation Information : Yadav S. Indoxacarb Toxicity: Treat the Patient, Not the Monitor. 2023; 2 (1):17-18.

DOI: 10.5005/jp-journals-11006-0038

License: CC BY-NC 4.0

Published Online: 07-03-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Here, we report the successful management of indoxacarb poisoning resulting in methemoglobinemia (MetHb) in a young female. Previously published literature has revealed the pathophysiology and occurrence of MetHb after indoxacarb ingestion requiring high oxygen therapy for treatment. Case description: A 25-year-old female presented with indoxacarb poisoning, resulting in MetHb. She was managed on room air despite the low saturation shown on pulse oximetry. She also received treatment with methylene blue (MB) and vitamin C. The patient recovered completely and was shifted to the ward. Conclusion: Through this case report, we want to highlight the lacunae in managing indoxacarb toxicity. We suggest that in-depth knowledge of the pathophysiology of indoxacarb toxicity and clinical observations are quintessential before the initiation/continuation of oxygen therapy in such cases. We also emphasize the importance of detailed history taking before initiating treatment with a drug like MB.

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