Methemoglobinemia Following Acute Novaluron–Emamectin Benzoate Ingestion: A Rare Case Report
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Abstract
Background: Novaluron and emamectin benzoate are insecticides widely used in agricultural regions of India. Human toxicity is uncommon, and methemoglobinemia is rarely reported.
Case Presentation: A 26-year-old male presented 3 hours after deliberate ingestion of approximately 500 mL of Barazide® (Novaluron 5.25% + Emamectin benzoate 0.9%). He had multiple episodes of vomiting. On admission, SpO₂ was 80% on room air, 86% on 6 L/min O₂, with normal hemodynamics. ABG showed falsely normal SO2 & PaO₂ with elevated methemoglobin levels up to 14.8%. Chest X-ray and ECG were normal. Gastric lavage was performed, and methylene blue was administered. Serial ABGs showed gradual normalization of methemoglobin levels.
Outcome: The patient improved clinically and was discharged stable on day 3.
Conclusion: This case highlights a rare presentation of methemoglobinemia due to novaluron–emamectin ingestion, emphasizing the need for early recognition and antidotal therapy.