Multimodal therapy successfully treats methemoglobinemia caused by emamectin benzoate and indoxacarb poisoning: a case report

Poisoning from emamectin benzoate combined with indoxacarb can cause neurological symptoms and methemoglobinemia, which may present clinically as confusion, cyanosis, dyspnea, and limb convulsions. In such cases, naloxone can be used to alleviate neurological symptoms, while high-dose vitamin C and low-concentration methylene blue can reduce methemoglobin (MetHb) to improve hypoxic symptoms. Hemoperfusion and continuous renal replacement therapy (CRRT) can rapidly remove exogenous and endogenous toxins from the blood, effectively protecting against organ damage to the heart, liver, and kidneys caused by emamectin benzoate poisoning.