{"title":"Case report: Pesticide-related methemoglobinemia: Tebufenozide and indoxacarb poisoning.","authors":"Jieru Wang, Guangcai Yu, Tianzi Jian, Baotian Kan, Wei Li, Xiangdong Jian","doi":"10.3389/ftox.2025.1557990","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Methemoglobinemia can be inherited or acquired. Acquired forms are more common due to drugs or poisonous substances that oxidize hemoglobin, and pesticide-related cases are notably rare.</p><p><strong>Case presentation: </strong>We report a 69-year-old woman who ingested 30 mL of tebufenozide and indoxacarb and was asymptomatic for 3 h; however, the patient was admitted to the hospital after 8 h, unconscious, with tachypnea, cyanosis, and 61.9% methemoglobin. The patient was administered methylene blue, mechanically ventilated, and hemoperfused. Subsequently, the patient recovered and was discharged with no discomfort and with normal laboratory test results.</p><p><strong>Conclusion: </strong>Tebufenozide and indoxacarb may cause methemoglobinemia, leading to cyanosis, unconsciousness, and respiratory failure; therefore, they should be handled with care in clinical practice.</p>","PeriodicalId":73111,"journal":{"name":"Frontiers in toxicology","volume":"7 ","pages":"1557990"},"PeriodicalIF":3.6000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903720/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in toxicology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/ftox.2025.1557990","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"TOXICOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Methemoglobinemia can be inherited or acquired. Acquired forms are more common due to drugs or poisonous substances that oxidize hemoglobin, and pesticide-related cases are notably rare.
Case presentation: We report a 69-year-old woman who ingested 30 mL of tebufenozide and indoxacarb and was asymptomatic for 3 h; however, the patient was admitted to the hospital after 8 h, unconscious, with tachypnea, cyanosis, and 61.9% methemoglobin. The patient was administered methylene blue, mechanically ventilated, and hemoperfused. Subsequently, the patient recovered and was discharged with no discomfort and with normal laboratory test results.
Conclusion: Tebufenozide and indoxacarb may cause methemoglobinemia, leading to cyanosis, unconsciousness, and respiratory failure; therefore, they should be handled with care in clinical practice.
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