Management and prognosis of acute Emamectin Benzoate poisoning in a human

Emamectin Benzoate (EB) is a semi-synthetic insecticide which was primarily created to combat lepidopteron insects. EB disrupts the neurotransmitters Gamma Amino Butyric Acid (GABA) through enhancing permeability of membrane chloride ion, resulting in the loss of cell function progressing to irreversible paralysis in invertebrates. Poisoning with EB in humans is rare; till date with just about five reported cases, two of which resulted in fatalities. Scarcity of treatment management information may cause a delay in the initiation of treatment, which is often general therapy rather than specific. By reporting this rare case of poisoning in human, the researchers wish to add value to the existing information and aid in forming a standard management of EB poisoning in humans. Here within, we report an acute case of EB poisoning in an adult male with no history of co-morbidities, had allegedly consumed approximately 125 mL of EB 1.9 % and, presented with complaints of vomiting, profuse sweating and drowsiness. The patient was treated with gastric lavage, fluid replenishment, and other supportive as well as symptomatic measures. The prognosis of the patient was guarded and care has been taken not to administer any Central Nervous System (CNS) depressants. Fortunately, the patient was discharged from the hospital by day 4 without any sequelae. [Display omitted] •Till date only six cases (5 cases, 1 case series) have been reported among which two cases reported fatalities.•Emamectin Benzoate poisoning is rare, and the prognosis is usually guarded. However, presence of any CNS depressants i.e., alcohol, diazepams etc. could worsen the prognosis.•Emamectin Benzoate is poorly absorbed when consumed orally and rapidly eliminated with half-lives of roughly 1.5 days. Toxicokinetics in humans has not yet been established.