Accidental Naphthalene Mothball Ingestion Leading to Methemoglobinemia and Severe Intravascular Haemolysis in a 3-Year-Old Girl: A Case Report

Neeta Kaluram  Hatkar; Mrinal Bhor

Neeta Kaluram Hatkar Professor and Head, Department of Paediatrics, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
Mrinal Bhor Junior Resident, 3rd Year MD, Department of Paediatrics, Shri Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India

Keywords: Naphthalene poisoning, Methemoglobinemia, Haemolytic anaemia, Methylene blue, Child, Case report

Abstract

Ingestion of naphthalene-containing mothballs is a well-recognised cause of acquired methaemoglobinemia and haemolytic anaemia in young children, particularly in developing countries. We report a 3-year-old girl who developed profound cyanosis, severe anaemia and haemoglobinuria after unintentional ingestion of mothballs. Admission haemoglobin was critically low, requiring two packed red-cell transfusions, while serial laboratory results confirmed ongoing intravascular haemolysis with elevated indirect bilirubin, reticulocytosis and markedly reduced haptoglobin. Methemoglobinemia was documented during the hospital course, with a measured methaemoglobin level of 8.8%. Intravenous methylene blue (1.5 mg/kg), blood products and supportive care resulted in a complete recovery. This case emphasises distinctive laboratory patterns and the importance of early suspicions of common household toxins among paediatric patients.

How to cite this article:
Hatkar N K, Bhor M S. Accidental Naphthalene Mothball Ingestion Leading to Methemoglobinemia and Severe Intravascular Haemolysis in a 3-Year-Old Girl: A Case Report. Postgrad J Pediatr Adol Med. 2026;3(1): 13-16.

References

Sanctucci K, Shah B. Association of naphthalene with acute hemolytic anemia. Academic Emergency Medicine. 2000 Jan;7(1):42-7. [Google Scholar] [PubMed]

Lim HC, Poulose V, Tan HH. Acute naphthalene poisoning following the non-accidental ingestion of mothballs. Singapore Med J. 2009 Aug 1;50(8):e298- 301. [Google Scholar] [PubMed]

Abuelo JG. Renal failure caused by chemicals, foods, plants, animal venoms, and misuse of drugs: an overview. Archives of internal medicine. 1990 Mar 1;150(3):505-10. [Google Scholar] [PubMed]