Acute intravascular hemolysis due to naphthalene toxicity: A case report

Abstract

Background: Naphthalene (mothball) is a commonly used deodorizer in the Indian subcontinent, including Sri Lanka. Though it is freely available around this country, poisoning has never been reported in the literature. Ingestion, either accidental or by deliberate self-harm, can occur due to its abundance as well as its candy-resembling appearance. Case Presentation: A 33-year-old Sri Lankan woman presented to us 2 days after the self-ingestion of 15 naphthalene balls. She had features of intravascular hemolysis without features of pigment nephropathy or methemoglobinemia. She was symptomatically managed with blood transfusion and adequate hydration. Conclusion: Naphthalene ingestion can lead to severe intravascular hemolysis as well as methemoglobinemia. The resultant pigment nephropathy may also lead to acute kidney injury.