Bengaluru: Abhaas (name changed), a 5-year-old boy was rushed to Columbia Asia Hospital, Whitefield on one fateful day with recurrent vomiting, sudden onset of paleness and bluish discolouration of the body along with decreased urine output soon after accidentally consuming naphthalene balls.
On examination in Emergency Department, it was found that he had very low oxygen levels in the body and was getting drowsier with every passing minute. He was immediately shifted to PICU where an evaluation revealed that he had developed severe hemolysis and Methaemoglobunemia secondary to naphthalene ball poisoning and G6PD deficiency.
Hemolyticanemia is secondary to extensive RBC cell disruption leading to oxygen-deprived state in the body. Methaemoglobunemia is the condition in which haemoglobin becomes abnormally functioning further adding on to severe hypoxia to the tissues. G6PD is an enzyme required for normal functioning of the red blood cells. Its deficiency perceives no symptoms but if exposed to certain medications (as in this case Naphthalene balls) causing oxidative stress, may lead to bursting of RBCs.
“Fortunately, Abhaas was saved on time. He received blood transfusions to correct severe anaemia. With prompt and appropriate management, the child started improving. In the next few days, methaemoglobulin levels showed a gradual decrease and hence there was an improvement in oxygen and saturation levels. He completely recovered and was discharged after 4 days of PICU stay,” said Dr. S P Senthil Kumar, Consultant Pediatric, Neonatal and Cardiac Intensivist, Columbia Asia Hospital, Whitefield.
Dr. Senthil also added that on an average they see 3-4 cases a month involving ingestion of harmful chemicals, acids, pesticides, oils, paints, medicine, camphor, button batteries leading to pneumonitis, food pipe and gastric erosions, encephalopathy with seizures, liver and kidney injury and sometimes it can be life threatening too!!
Adverse events can be prevented by-
-Keeping toxic substances not only far away from children’s approach but also hidden from their eyes
-Medications to be kept in closed locked cabinets
-Proper labelling
-Use of child-resistant containers and packaging
-Avoidance of highly toxic substances at home
What to do if a child accidentally consumes toxic substances?
-Watch for warning signs–recurrent vomiting, fever, bluish discolouration of lips and fingers, breathing difficulty, persistent cough, fits, increased irritability or drowsiness, jaundice, abdominal pain, decreasing urine output and poor oral intake
-Rush to the nearest hospital
-Don’t induce vomiting in case of acid, bleach, detergent, petroleum distillates, mosquito repellents, toxic oils ingestion
