AUTHOR=Wang Jieru , Yu Guangcai , Jian Tianzi , Kan Baotian , Li Wei , Jian Xiangdong 

TITLE=Case report: Pesticide-related methemoglobinemia: Tebufenozide and indoxacarb poisoning

JOURNAL=Frontiers in Toxicology

VOLUME=Volume 7 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2025.1557990

DOI=10.3389/ftox.2025.1557990

ISSN=2673-3080

ABSTRACT=BackgroundMethemoglobinemia 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 PresentationWe 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.ConclusionTebufenozide and indoxacarb may cause methemoglobinemia, leading to cyanosis, unconsciousness, and respiratory failure; therefore, they should be handled with care in clinical practice.