![]() Injection of metallic mercury can lead to a rapid increase of circular mercury in a short time, and finally distributes throughout the body. Metallic mercury poisoning through intravenous administration is quite rare, especially for homicide. Other causes of metallic mercury poisoning in medical practice settings have also been reported, such as the release of metallic mercury from dental amalgam, and mercury leakage from medical devices. Acute vapor exposure of metallic mercury can cause respiratory distress, and chronic exposure may induce damages in central nervous system and kidney. Metallic mercury poisoning is usually caused through inhalation of its vapor, which may occur at home or laboratory through the broken thermometers containing mercury. Metallic mercury is volatile and highly lipophilic. It has 3 forms in nature: metallic, inorganic, and organic mercury compounds. Mercury is the only metal that remains in liquid state at room temperature with high toxicity. It should be concerned about the combined use of chelation agents and other treatments, such as surgical excision, hemodialysis and plasma exchange in clinical settings. Lessons:Įarly diagnosis and appropriate treatment are critical for intravenous mercury poisoning. However, in case 2, the patient's dyspnea was getting worse and he finally died due to toxic encephalopathy and respiratory failure. The laboratory test results and organ function of the patient in case 1 gradually returned to normal. Blood irrigation and chelation therapy were performed in case 2. Surgical excision, continuous blood purification, plasma exchange, alveolar lavage, and chelation were performed successively in case 1. The diagnosis was then confirmed with a urinary mercury concentration of 4828 mg/L. On further questioning, the patient's girlfriend acknowledged that she injected him about 40 g mercury intravenously 11 days ago. Imaging studies revealed multiple high-density spots throughout the body especially in the lungs. The patient's condition in case 1 was deteriorated after initial treatment. Another case is that of a 29-year-old male who committed suicide by injecting himself metallic mercury 15 g intravenously and presented with dizzy, dyspnea, fatigue, sweatiness, and waist soreness. Patient concerns:Ī 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. Diagnosis and treatment of the disease are challenging. Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Received in revised form October 22, 2017 The work cannot be used commercially without permission from the journal. #Mercury poisoning symptoms licenseThis is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The authors report no conflicts of interest. Department of Forensic Medicine, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China.Ĭorrespondence: Zilong Liu, Department of Forensic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China (e-mail: ).Ībbreviations: α- HBDH = α- hydroxybutyrate dehydrogenase, ALT = alanine aminotransferase, AST = aspartate aminotransferase, CT = computed tomography, DMPS = sodium dimercaptosulphonate, DMSA = dimercaptosuccinic acid, Hb = hemoglobin, LDH = lactate dehydrogenase, TP = total protein, WBC = white blood cell.įunding: This study was supported by the Fundamental Research Funds for the Central Universities, HUST: NO. ![]()
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