Naphthalene or Mothball Poisoning Manifesting as Acute Intravascular Hemolysis and Acquired Methemoglobinemia

TL;DR

A 22-year-old man developed severe health issues after ingesting naphthalene, requiring specific treatments like methylene blue and blood transfusions.

Contribution

This case report highlights naphthalene poisoning as a rare but serious condition and emphasizes specific treatment approaches.

Findings

Ingestion of six naphthalene balls caused acute intravascular hemolysis and methemoglobinemia.

Treatment included red blood cell transfusions, methylene blue, ascorbic acid, and N-acetyl cysteine.

Abstract

Naphthalene is a major component of mothballs. Domestically, people use mothballs as an insect repellent. Its deliberate or accidental ingestion leading to toxicity has rarely been reported in the medical literature, despite its widespread use in Southeast Asia. Naphthalene, or mothball poisoning, is a rare but serious condition that can have detrimental effects on human health. This case report presents the clinical course of a 22-year-old male who ingested six naphthalene balls, resulting in severe symptoms including fever, abdominal pain, vomiting, jaundice, and dark-colored urine. Laboratory investigations were suggestive of acute intravascular hemolysis and methemoglobinemia. The patient was promptly admitted to the hospital, where he received supportive care along with specific treatment in the form of red blood cell transfusions, intravenous methylene blue, ascorbic acid, and N-acetyl cysteine. Through this report, the importance of raising awareness about the dangers of naphthalene poisoning and the specific treatment options available is highlighted.