Mercury poisoning through intravenous administration

Abstract

Rationale:Metallic mercury poisoning through intravenous injection is rare, especially for a homicide attempt. Diagnosis and treatment of the disease are challenging.Patient concerns:A 34-year-old male presented with pyrexia, chill, fatigue, body aches, and pain of the dorsal aspect of right foot. 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.Diagnosis:The patient's condition in case 1 was deteriorated after initial treatment. Imaging studies revealed multiple high-density spots throughout the body especially in the lungs. On further questioning, the patient's girlfriend acknowledged that she injected him about 40 g mercury intravenously 11 days ago. The diagnosis was then confirmed with a urinary mercury concentration of 4828 mg/L.Interventions:Surgical excision, continuous blood purification, plasma exchange, alveolar lavage, and chelation were performed successively in case 1. Blood irrigation and chelation therapy were performed in case 2.Outcomes:The laboratory test results and organ function of the patient in case 1 gradually returned to normal. However, in case 2, the patient's dyspnea was getting worse and he finally died due to toxic encephalopathy and respiratory failure.Lessons:Early diagnosis and appropriate treatment are critical for intravenous mercury poisoning. 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.

Comparative pharmacokinetics and urinary excretion of arsenic and mercury after oral administration of realgar, cinnabar and AnGongNiuHuang Pill to rats

“…The U.S. Federal Biological Exposure Index of mercury was 50 μg/L in urine ( Kamensky et al, 2019 ). A clinical case reported patients with urinary mercury concentrations of 4,828 μg/L or 458 nmol/L were diagnosed with poisoning ( Lu Q. Y. et al, 2017 ). No related toxicity occurred in 30 days realgar treated rats, and the urinary arsenic concentrations were 10.30 and 3.48 μg/ml at 1–12 and 12–24 h, respectively ( Yi et al, 2019 ; Yi et al, 2020 ).…”

Another umbrella murder? – A rare case of Minamata disease

“…Mercury intoxications are especially known from the public health disasters in Minamata and Iraq [ 5 , 6 ]. There are just a few reports regarding homicides or suicides by mercury compounds [ 12 – 14 ]. The common factor in most cases is that victims or perpetrators of mercury intoxications had access to mercury compounds due to their profession [ 12 ].…”

“…Nowadays, suicides as well as homicides with mercury compounds are rare [12][13][14][15]. Nevertheless, there are several reports of homicidal, suicidal and accidental mercury intoxications in the last centuries.…”

“…This could be explained by the fact that mercury was used as treatment of different diseases and for that reason easily available [16]. The cases which have occurred in recent years are often associated with victims or perpetrators who are in contact with mercury compounds due to their profession [12]. A well-known example for an accidental mercury intoxication is the case of Karen Wetterhahn (American professor of chemistry) who died from a Dimethylmercury intoxication caused by wearing insufficiently protective gloves [17].…”

Socio-Economic and Environmental Implications of Gold Mining in Afro-Descendant Communities from Colombia

“…Unfortunately, once in humans, this element affects different target organs, including the nervous system, kidneys, and liver, causing mental disorders and damage to the motor, reproductive, speech, vision, and hearing systems. Various studies have reported severe cases of poisoning and death due to contamination with this metal [75,76]. When ingested by pregnant women, MeHg has the ability to cross the placental barrier, accumulating in the brain and central nervous system of the developing fetus [77].…”