Newborn with Perinatal Naphthalene Toxicity after Maternal Ingestion of Mothballs during Pregnancy

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.