2023; 6(1): 29-35

DOI: 10.32114/CCI.2023.6.1.29.35
Published online: 2023-03-31 (first online 2023-01-22)

Acute naphthalene toxicity following ingestion of mothballs and ethyl alcohol: a case report.

Nikesh Kumar Roshan [1] , Kirti Vishwas [1] , Neeraj Kumar [2] .

[1] Division of Critical Care Medicine, Big Apollo Spectra Hospitals, Bihar, India.
[2] Department of Anaesthesiology, All India Institute of Medical Sciences, Patna, India.

    Abstract:

Abstract [EN]   - Naphthalene poisoning is an uncommon poisoning due to its pungent smell, taste, insolubility in water, and poor absorption from the gut following exposure to naphthalene-containing compounds such as mothballs. Paradichlorobenzene has been reported to dissolve more quickly in alcohol. Within a period of 48-96 hours following naphthalene mothball exposure patient presents with acute onset of non-bloody bilious vomiting, dark brown urine and watery diarrhoea. We present a diagnostic and therapeutic challenge while treating a 27 years old male admitted to the intensive care unit with features of acute naphthalene-toxicity, methemoglobinemia and acute kidney injury following accidental ingestion of mothballs and ethyl alcohol. His vital signs at the time of intensive care unit admission included fever, tachycardia, and hypotension, and his laboratory workup demonstrates hyperbilirubinemia with indirect predominance, hemolytic anaemia, methemoglobinemia, and renal dysfunction. Treatment options include supportive care, red cell transfusion, ascorbic acid, methylene blue, and N-acetylcysteine. The importance of obtaining a careful history and clinical findings is of paramount importance, especially in making the right diagnosis and a successful outcome largely depends on it.

Streszczenie [PL]   - Zatrucie naftalenem jest rzadkim zatruciem ze względu na jego ostry zapach, smak, nierozpuszczalność w wodzie i słabą absorpcję z jelit po ekspozycji na związki zawierające naftalen, takie jak kulki na mole. Donoszono, że paradichlorobenzen rozpuszcza się szybciej w alkoholu. W okresie 48-96 godzin po narażeniu na naftalen występuje ostry początek niekrwawych żółciowych wymiotów, ciemnobrązowego moczu i wodnistej biegunki. Przedstawiamy wyzwanie diagnostyczno-terapeutyczne w leczeniu 27-letniego mężczyzny przyjętego do kliniki chirurgicznej oddziału intensywnej terapii z cechami ostrego zatrucia naftalenem, methemoglobinemią i ostrym uszkodzeniem nerek po przypadkowym spożyciu kulek na mole i spożyciu alkoholu etylowego. Jego parametry życiowe w momencie przyjęcia na oddział intensywnej terapii obejmowały gorączkę, tachykardię i niedociśnienie, a wyniki badań laboratoryjnych wykazały hiperbilirubinemię pośrednią, niedokrwistość hemolityczną, methemoglobinemię i dysfunkcję nerek. Opcje leczenia obejmowały wspomagającą pielęgnację, transfuzję krwinek czerwonych, kwas askorbinowy, błękit metylenowy i N-acetylocysteinę. Znaczenie uzyskania szczegółowego wywiadu i wyniki kliniczne mają ogromne znaczenie, zwłaszcza w postawieniu właściwej diagnozy i pomyślnym przeprowadzeniu terapii.

    Citation:

VANCOUVER FORMAT

Roshan NK, Vishwas K, Kumar N. Acute naphthalene toxicity following ingestion of mothballs and ethyl alcohol: a case report. Crit. Care Innov. 2023; 6(1): 29-35.
DOI: 10.32114/CCI.2023.6.1.29.35

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