Abhay a 5 year- old child, had accidentally swallowed a naphthalene ball which had resulted in Haemolytic anaemia and Methemoglobinemia with G6PD deficiency leading to very low oxygen levels in his body.
He was immediately rushed to Columbia Asia Hospital Whitefield with severe jaundice and pallor (pale skin), Abhay was also complaining of vomiting and decreased urine output within a few hours after the ingestion.
He was directly admitted in the paediatric intensive care unit (PICU) for further examinations. He was very drowsy during the treatment hours. His Initial investigations revealed G6PD deficiency, due to which the boy suffered from haemolysis reaction and severe anaemia which is a life threating condition for the patient, wherein the red blood cells get busted and settle in kidneys resulting in kidney failure. But fortunately Abhay was saved before this could happen.
“G6PD is required for normal functioning of red blood cells. Its deficiency perceives no symptoms but if exposed to medicines causing oxidative stress may lead to bursting of RBC and the filter of haemoglobin so quick & fast ultimately ending in kidney failure.
Clinically he didn’t have any feverish symptoms and was also free from seizure and respiratory distress.
The blood was transfused as a result of severe haemolysis, with injection. In next few days methemoglobin levels showed a gradual decrease. His urine output was nil and Diuresis done along with other supportive medications. Methylene blue injection was prescribed after checking for G6PD status.
“During the hospital stay, there was gradual improvement in saturation along with urine colour, and also the pale skin was turning out to be healthy with the decrease in jaundice too. The patient recovered well and will not suffer from any problem in near future” said Dr Senthil Kumar, Consultant Paediatric, Neonatal & Cardiac Intensivist, Columbia Asia Hospital Whitefield
Advise for parents
1. Parents must ensure that the naphthalene balls/ mothballs must be kept away from the reach of children.
2. Directions to use naphthalene balls must be followed carefully. These balls are suggested to be used on or around clothing and not in the attic area, on ground or in the eaves.
3. Proper washing of clothing and bedding has to be done before wearing or using it.
4. Disposal of old/ unused Naphthalene balls should be done timely.
Kindly respond to the below questions for us to incorporate more details:
• What was the initial condition of the child when he was admitted in the hospital?
• How many days he was there at the hospital?
• Quote from the patient or parents?
• How many such accidental ingestion cases does the hospital witness every year.
• Any other tips/ advice the doctor would like to give regarding the usage of naphthalene balls.
• Immediate steps/ precautions to be taken after the accident, before coming to the hospital.