COVID-19 and Stress: A Young Male Presenting with Central Cyanosis, Dark Urine, Oliguria, Jaundice and Anemia due to Methemoglobinemia as a result of Suicidal Naphthalene Mothball Poisoning Recovered with Exchange Transfusion

A young man presented with abdominal pain and vomiting after eating Naphthalene Mothball. He had dyspnea, central cyanosis (SaO2 on air was 67% air), marked pallor, deep jaundice dehydration. His urine color black; and, his plasma in clotted blood sample brownish. treated as methemoglobinemia due to suicidal Mothball poisoning fluid electrolyte replacement, ascorbic acid, N-acetylcystine exchange transfusion twice four units of whole blood. Dramatic improvement immediately following transfusion. Psychiatric consultation counselling were done; he admitted the main reason for committing suicide socioeconomic stress COVID-19.