Acute naphthalene poisoning following the non-accidental ingestion of mothballs

Lim HC, Poulose V, Tan HH
Correspondence: Dr Tan Hock Heng, hock_heng_tan@cgh.com.sg

ABSTRACT
Ingestional naphthalene mothball poisoning leading to prolonged haemolysis and methaemoglobinaemia can present with diagnostic and therapeutic challenges. A 19-year-old woman ingested 12 mothballs, and presented two days later with haemolysis and methaemoglobinaemia. She was treated with red blood cell transfusions, intravenous methylene blue, N-acetylcysteine and ascorbic acid. Continuous venovenous haemofiltration was conducted for 45 hours. Haemolysis with anaemia and methaemoglobinaemia persisted even after five days post-ingestion. Clinical and biochemical parameters improved. We describe a case of ingestional naphthalene poisoning with a good outcome after treatment.

Keywords: haemolysis, methaemoglobinaemia, mothball ingestion, naphthalene, poisoning
Singapore Med J 2009; 50(8): e298-e301