Naphthalene toxicity in a patient with G6PD deficiency

Naphthalene, an aromatic hydrocarbon prevalent in mothballs and deodorizers, poses significant health risks upon exposure, primarily through ingestion or dermal absorption. Herein, we report the case of a previously healthy 28-year-old male who presented with hemolysis, methemoglobinemia, and acute renal failure. The patient had a history of ingestion of mothballs, mistaking them for candy, prompting consideration of naphthalene intoxication as the clinical diagnosis, which was subsequently confirmed by laboratory findings. Given concurrent hepatic dysfunction and a diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency, N-acetyl cysteine was administered instead of methylene blue. The patient’s condition improved after he was managed with aggressive fluid resuscitation, noninvasive ventilation, blood transfusions, and hemodialysis. Naphthalene ingestion can result in hemolysis, methemoglobinemia, and acute kidney injury, with heightened susceptibility observed in patients with G6PD deficiency.