We recommend that cases of subcutaneous metallic mercury injection should be managed by complete surgical excision of the granuloma under X ray control and serial monitoring of blood and urine mercury concentrations.

Sodium nitrite is used commercially as a coloring agent, a food preservative and a corrosion inhibitor. Accidental poisoning usually results from the ingestion of contaminated food and water and causes gastrointestinal irritation, vasodilatation and methemoglobinemia with subsequent tissue hypoxia. We describe an unusual case of sodium nitrite-induced methemoglobinemia following the ingestion of drinking water contaminated with a corrosion inhibitor. To our knowledge this is the first report of such a case.

Animal studies demonstrate that diethyldithiocarbamate is an effective antidote in acute nickel carbonyl poisoning when it is administered parenterally soon after exposure. However, as no adequately controlled clinical studies have been performed, further clinical data are required before diethyldithiocarbamate can be recommended routinely in acute nickel carbonyl poisoning. If diethyldithiocarbamate is to be employed, it should be administered parenterally soon after exposure as delay in administration may increase nickel carbonyl toxicity. There are currently insufficient data to recommend disulfiram as an alternative to diethyldithiocarbamate even when diethyldithiocarbamate is not available.

Introduction: Detergents used in automatic dishwashing machines are of two main types: traditional tablets that require removal from an external wrapper and newer soluble film tablets. Objective: To determine the toxicity of automatic dishwashing tablets. Methods: Telephone enquiries to the UK National Poisons Information Service were analysed for the period January 2008 to June 2019. Results: Ingestion: Ingestion was involved in 798 traditional tablet exposures and 725 soluble film exposures. Clinical features (Poisoning Severity Score ≥ 1) developed in 22.2% of patients ingesting traditional tablets and in 28.8% ingesting soluble film tablets; moderate or severe toxicity was rare (<0.5% for both traditional and soluble film tablets). Children (≤5 years) significantly ( p < 0.0001) more often developed features following ingestion of soluble film ( n = 193, 28.2%) than traditional tablets ( n = 134, 19.1%). In contrast, adults more often developed features following ingestion of traditional than soluble film tablets, although this difference was not statistically significant. Eye exposure: The eye was involved in only 26 of 1539 exposures; 17 of 26 exposures resulted in ocular features. The most commonly reported features were conjunctivitis, eye pain and blurred vision, although one patient sustained a corneal abrasion and developed loss of vision. Skin exposure: Thirty-four of 1539 exposures involved the skin but only 3 developed dermal features which were minor. Conclusions: Children (≤5 years) significantly more often developed features following ingestion of soluble film than traditional tablets, although the likelihood of a child developing features was relatively low (<30%) and features that did develop were almost always mild. In contrast, adults more often developed features following the ingestion of traditional than soluble film tablets. Overall, the eye was involved in only 1.7% of exposures and only one patient sustained a corneal abrasion.