Acute mercury poisoning complicated by gastrointestinal bleeding
DOI:
https://doi.org/10.18203/2349-3933.ijam20241024Keywords:
Mercury poisoning, Acute poisoning, Poisoning, GI bleeding due to mercury poisoning, Complicated mercury poisoning, Acute mercury poisoning treatmentAbstract
Mercury poisoning is a rare but potentially serious condition that can result from environmental exposure to elemental mercury. We present a case of a 22-year-young male who presented to the emergency department (ED) with symptoms of mercury poisoning after his family members brought home a vial of elemental mercury. The patient experienced nausea, anxiety, abdominal pain, diarrhea, and fever. Despite normal initial laboratory tests and imaging studies, a presumptive diagnosis of mercury poisoning was made based on the patient's history of exposure and clinical presentation. Although his hospital stay was complicated by passage of blood in stool, possibly lower GI bleed, but treatment with N-acetylcysteine (NAC) was initiated empirically, leading to resolution of symptoms and a favorable outcome. This case highlights the importance of considering mercury poisoning in patients with appropriate exposure history and the effectiveness of NAC in the treatment of acute mercury poisoning. Public education on the hazards of mercury and the importance of prompt recognition and treatment are essential in preventing severe complications associated with mercury exposure.
References
Caravati EM, Erdman AR, Christianson G, Nelson LS, Woolf AD, Booze LL, et al. American Association of Poison Control Centers. Elemental mercury exposure: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2008;46:1-21.
Mackowiak PA, Durack DT. Fever of unknown origin. Principles and Practice of Infectious Diseases: Volume 1. Edited by: Mandell GL, Bennett JE, Dolin R. Philadelphia: Churchill Livingstone. 2010;779-89.
Nemery B. Metal toxicity and the respiratory tract. Eur Respir J. 1990;3:202-19.
Nakayama H, Shono M, Hada S. Mercury exanthem. J Am Acad Dermatol. 1984;13:848-52.
Fischbach FT. A manual of laboratory & diagnostic testing. 4. Philadelphia: J.B. Lippincott Company. 1992;214-6.
Ford MD. In: Emergency Medicine: A Comprehensive Study Guide. 5. Tintinalli JE, Kelen GD, Stapczynski JS, editor. Newyork, McGraw Hill. Metals and Metalloids: Mercury. 1999;1191-3.
Skerfving SB, Copplestone JF. Poisoning caused by the consumption of organomercury-dressed seed in Iraq. Bull World Health Organ. 1976;54(1):101-12.
Yee S, Choi BH. Oxidative stress in neurotoxic effects of methylmercury poisoning. Neurotoxicology. 1996;17(1):17-26.
Takeuchi T. Pathology of Minamata disease. With special reference to its pathogenesis. Acta Pathol Jpn. 1982;32(1):73-99.
Blanusa M, Varnai VM, Piasek M, Kostial K. Chelators as antidotes of metal toxicity: therapeutic and experimental aspects. Curr Med Chem. 2005;12:2771-94.
