Auto-aggressive metallic mercury injection around the knee joint: a case report

Abstract

BackgroundAccidental or intentional subcutaneous and/or intramuscular injection of metallic mercury is an uncommon form of poisoning. Although it does not carry the same risk as mercury vapour inhalation, it may cause destructive early and late reactions.Case PresentationHerein we present the case of a 29-year-old male patient who developed an obsessive-compulsive disorder causing auto-aggressive behaviour with injection of elemental mercury and several other foreign bodies into the soft tissues around the left knee about 15 years before initial presentation. For clinical examination X-rays and a CT-scan of the affected area were performed. Furthermore, blood was taken to determine the mercury concentration in the blood, which showed a concentration 17-fold higher than recommended. As a consequence, the mercury depots and several foreign bodies were resected marginally.ConclusionBlood levels of mercury will decrease rapidly following surgery, especially in combination with chelating therapy. In case of subcutaneous and intramuscular injection of metallic mercury we recommend marginal or wide excision of all contaminated tissue to prevent migration of mercury and chronic inflammation. Nevertheless, prolonged clinical and biochemical monitoring should be performed for several years to screen for chronic intoxication.

Metallic Mercury in the Soft Tissues of the Hand: Case Report

“…К редким клиническим наблюдениям относится проникновение в организм человека элементной металлической ртути. Ртуть представляет собой металл, способный находиться в жидкой форме при комнатной температуре, она содержится внутри различных электронных приборов, термометров, манометров, ртутных ламп, используется для изготовления мазей, зубных амальгам [8,22,23,24]. Вредное воздействие металлической ртути на организм во многом зависит от пути ее введения.…”

“…В последующие годы (после 2003 г.) еще ряд авторов представили клинический анализ случаев (от 1 до 4) подкожного введения ртути, в том числе и ятрогенной этиологии [8,22,24,25,26,27,28].…”