en pharmacology pharmacology case report case report <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="color:#0000ff;"><strong><em>Background</em></strong><em>:</em></span> Hexaflumuron is a benzoyl urea pesticide widely used in agriculture. This is the first case of severe toxicity of hexaflumuron.<br> <span style="color:#0000ff;"><strong><em>Case presentation:</em></strong> </span>A 51-year-old man was admitted to the poisoning ward of the Emam-Reza Hospital for loss of consciousness and hypotension secondary to pesticide toxicity. He had metabolic acidosis, bradycardia, and diffuse erythematous skin color change in the abdomen and legs. The results of toxicology tests were negative except positive test result for tricyclic antidepressants in immunochromatographic assay of urine. He was treated with normal saline, norepinephrine infusion and bicarbonate. His intoxication finally resulted to cardiac arrest and death on the 4^thday of hospitalization, secondary to septic shock.<br> <span style="color:#0000ff;"><strong><em>Conclusion:</em></strong></span> Acute poisoning with hexaflumuron can be life-threatening, thought its LD₅₀is greater than 5000 mg/kg. It may change the patient&rsquo;s skin color to cherry and cause hypotension, loss of consciousness and metabolic acidosis, however, conclusive evidence to support these assumptions are required.</span></span> Acute poisoning, Hexaflumuron, pesticide 119 123 http://caspjim.com/browse.php?a_code=A-10-1740-1&slc_lang=en&sid=1 Maryam Sayyari Dougabadi sayyaridm1@mums.ac.ir 100319475328460027385 100319475328460027385 Yes Deparment of emergency medicine, faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Leila Etemad etemadl@mums.ac.ir 100319475328460027386 100319475328460027386 No Medical Toxicology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mohammad Moshiri moshirim@mums.ac.ir 100319475328460027387 100319475328460027387 No Department of Clinical Toxicology and Poisoning, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran