Indoxacarb-Related ARDS, Neurotoxicity and Orange Urine

A 17 year old male developed adult respiratory distress syndrome (ARDS), seizures, intravascular hemolysis and peripheral neuropathy following self-poisoning with a pesticide containing 14.5% indoxacarb. He was managed conservatively with fluid management, antibiotics, mechanical ventilation and physiotherapy. There is limited data concerning the human toxicity of indoxacarb. This case demonstrates that findings from animal studies, such as seizures, respiratory distress, and intravascular hemolysis are possible following self-poisoning in humans. In this patient, partial recovery was achieved following supportive care.