Clinical Characteristics of Patients with Indoxacarb Insecticide Poisoning.
- Author:
Sang Min JUNG
1
;
Kyung Woo LEE
;
Tae Shin KANG
Author Information
1. Department of Emergency Medicine, School of Medicine, Gyeongsang National University, Jinju, Korea.
- Publication Type:Original Article
- Keywords:
Indoxacarb;
Insecticide;
Methemoglobinemia;
Poisoning
- MeSH:
Anemia, Hemolytic;
Ascorbic Acid;
Cyanosis;
Dyspnea;
Eating;
Emergencies;
Heart Arrest;
Heart Failure;
Humans;
Hypotension;
Medical Records;
Methemoglobin;
Methemoglobinemia;
Methylene Blue;
Oxazines;
Pancreatitis;
Pneumonia;
Retrospective Studies;
Rhabdomyolysis;
Seizures
- From:Journal of the Korean Society of Emergency Medicine
2013;24(2):188-198
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Indoxacarb insecticide poisoning causes methemoglobinemia, which is occasionally life-threatening. However, there is limited data on indoxacarb effects after human ingestion. The purpose of this study was to examine the clinical features, complications, management, and medical outcome of patients with indoxacarb insecticide poisoning. METHODS: We retrospectively reviewed the medical records of 10 patients with indoxacarb insecticide poisoning who had visited our emergency centers from January 2008 to December 2011. We collected data on the general characteristics of the patients, their clinical symptoms and signs, laboratory data, management of their condition, and clinical results. RESULTS: Among the 10 patients, 8 were diagnosed with methemoglobinemia. The clinical manifestations of indoxacarb insecticide poisoning were hypotension (3 patients), altered mentality (5 patients), cyanosis (5 patients), dyspnea (2 patients), seizure (3 patients), and cardiac arrest (2 patients). Four patients had a poisoning severity score of 3 and 2 patients had a poisoning severity score of 2. Four patients were treated with methylene blue for methemoglobinemia and one patient was treated with a high dose (150 mg/kg) of ascorbic acid. The serum methemoglobin saturation of five patients who were treated with methylene blue or a high dose of ascorbic acid was nearly normalized. Four patients experienced rhabdomyolysis, pneumonia, hemolytic anemia, acute pancreatitis, and heart failure as a complication of indoxacarb insecticide poisoning. CONCLUSION: We observed a variety of clinical features, complications, management, medical outcome, and clinical course of patients with indoxacarb insecticide poisoning. We could also ascertain the efficacy of methylene blue and high dose ascorbic acid for indoxacarb-induced metheglobinemia.
