Maternal ingestion of naphthalene-containing mothballs is an uncommon cause of perinatal toxicity. Naphthalene toxicity is associated with methemoglobinemia, hypotension, hemolytic anemia, and hyperbilirubinemia, as well as other hepatic, renal, and respiratory complications. Naphthalene exposure is a common cause of toxicity in older children, but is rarely described in neonates. The neonatal cases described in the literature focus primarily on maternal inhalation as opposed to ingestion. We present a case of perinatal toxicity due to repeated maternal ingestion of naphthalene-containing mothballs during pregnancy. The patient presented with methemoglobinemia, hypotension, hemolytic anemia, and hyperbilirubinemia. Sepsis or pulmonary hypertension were the initial working diagnoses, as the mother did not provide the history of ingestion until after the patient’s clinical status worsened. This case highlights the importance of obtaining a thorough maternal history and considering maternal ingestion when the etiology of symptoms is not clear.

1.
Gummin
DD
,
Mowry
JB
,
Spyker
DA
,
Brooks
DE
,
Osterthaler
KM
,
Banner
W
.
2017 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 35th Annual Report
.
Clin Toxicol (Phila)
.
2018
Dec
;
56
(
12
):
1213
415
.
[PubMed]
1556-3650
2.
Anziulewicz
JA
,
Dick
HJ
,
Chiarulli
EE
.
Transplacental naphthalene poisoning
.
Am J Obstet Gynecol
.
1959
Sep
;
78
(
3
):
519
21
.
[PubMed]
0002-9378
3.
Molloy
EJ
,
Doctor
BA
,
Reed
MD
,
Walsh
MC
.
Perinatal toxicity of domestic naphthalene exposure
.
J Perinatol
.
2004
Dec
;
24
(
12
):
792
3
.
[PubMed]
0743-8346
4.
Boynukalin
FK
,
Baykal
C
.
Prenatal diagnosis of multiple fetal anomalies in naphthalene-addicted pregnant women: a case report
.
Clin Exp Obstet Gynecol
.
2014
;
41
(
2
):
217
8
.
[PubMed]
0390-6663
5.
Sahni
M
,
Vibert
Y
,
Bhandari
V
, et al.
Newborn Infant With Mothball Toxicity Due to Maternal Ingestion.
Pediatrics (
2019
): e20183619–3619v1.
6.
Sudakin
DL
,
Stone
DL
,
Power
L
.
Naphthalene Mothballs: Emerging and Recurring Issues and their Relevance to Environmental Health
.
Curr Top Toxicol
.
2011
;
7
:
13
9
.
[PubMed]
0972-8228
7.
Kundra
TS
,
Bhutatani
V
,
Gupta
R
,
Kaur
P
.
Naphthalene Poisoning following Ingestion of Mothballs: A Case Report
.
J Clin Diagn Res
.
2015
Aug
;
9
(
8
):
UD01
02
.
[PubMed]
2249-782X
8.
Tsang
HL
,
Wu
S
,
Leung
CK
,
Tao
S
,
Wong
MH
.
Body burden of POPs of Hong Kong residents, based on human milk, maternal and cord serum
.
Environ Int
.
2011
Jan
;
37
(
1
):
142
51
.
[PubMed]
0160-4120
9.
Çok
I
,
Mazmanci
B
,
Mazmanci
MA
,
Turgut
C
,
Henkelmann
B
,
Schramm
KW
.
Analysis of human milk to assess exposure to PAHs, PCBs and organochlorine pesticides in the vicinity Mediterranean city Mersin, Turkey
.
Environ Int
.
2012
Apr
;
40
:
63
9
.
[PubMed]
0160-4120
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