Acute mercury poisoning presenting as fever of unknown origin in an adult woman: a case report

Abstract

IntroductionMercury intoxication may present in a wide range of clinical forms from a simple disease to fatal poisoning. This article presents a case of acute mercury poisoning, a rare condition that presents challenges for diagnosis with fever of unknown origin.Case presentationA 52-year-old Caucasian woman was admitted to the hospital with high fever, sore throat, a rash over her entire body, itching, nausea, and extensive muscle pain. She had cervical, bilateral axillary and mediastinal lymphadenopathies. We learned that her son and husband had similar symptoms. After excluding infectious pathologies, autoimmune diseases and malignancy were investigated. Multiple organs of our patient were involved and her fever persisted at the fourth week of admission. A repeat medical history elicited that her son had brought mercury home from school and put it on the hot stove, and the family had been exposed to the fumes for a long period of time. Our patient’s serum and urine mercury levels were high. She was diagnosed with mercury poisoning and treated accordingly.ConclusionsMercury vapor is a colourless and odorless substance. Therefore, patients with various unexplained symptoms and clinical conditions should be questioned about possible exposure to mercury.

Mercury poisoning through intravenous administration

“…Most metallic mercury poisoning cases have good prognosis (with or without a mild symptom or some sequelae), and only a few patients eventually died. [ 3 – 12 , 16 – 22 ] There are several effective methods of removing the mercury in the body. Surgically clear is useful for getting rid of the “mercury bank” in the injection site and has an effective effect in reducing circulating mercury levels and improving symptoms.…”

“…[ 1 , 2 ] Metallic mercury poisoning is usually caused through inhalation of its vapor, which may occur at home or laboratory through the broken thermometers containing mercury. [ 3 , 4 ] Acute vapor exposure of metallic mercury can cause respiratory distress, and chronic exposure may induce damages in central nervous system and kidney. [ 2 ] Other causes of metallic mercury poisoning in medical practice settings have also been reported, such as the release of metallic mercury from dental amalgam, [ 5 ] and mercury leakage from medical devices.…”

Mercury Exposure and Its Health Effects in Workers in the Artisanal and Small-Scale Gold Mining (ASGM) Sector—A Systematic Review

“…Acute cases of mercury poisoning can occur after contact with its metallic form [ 29 , 30 , 31 ]. Due to the inhalation of toxic fumes, the resulting symptoms affect, in particular, the pulmonary system with cough and dyspnoea up to acute respiratory distress syndrome (ARDS) [ 29 , 30 , 31 ].…”

Mercury Vapour Long-Lasting Exposure: Lymphocyte Muscarinic Receptors as Neurochemical Markers of Accidental Intoxication

“…This lasting intoxication, usually due to Hg vapour inhalation, is characterized by an initial flu-like syndrome, affecting at the outset the respiratory tract with symptoms of cough, sore throat, shortness of breath, and chest pain, then followed by signs affecting gastrointestinal, central, and peripheral nervous system, with a wide range of symptoms including fever, erythematous rash, itching, chills, gastrointestinal complaints, metallic taste, headache, and weakness. Anyway this “metal fume fever,” a syndrome commonly confused with a viral etiology, still remains a poorly understood syndromic picture [1]. …”

“…Nonetheless, chronic exposure to Hg vapour is also possible in domestic/nonoccupational setting. Particularly, with the wide utilization of Hg in thermometers, sphygmomanometers, and barometers, mainly used at home and in hospitals as well as in schools, an accidental breakage of these devices may cause spillage of Hg droplets resulting in a chronic elemental mercury intoxication [1–3]. …”