1/28. Lessons to be learned: a case study approach. An unusual case of alveolar deposition from swallowing metallic mercury in an attempt at self-poisoning.The authors report a case of deliberate self-poisoning in a drug addict who swallowed elemental mercury: in so doing he inadvertently acquired a permanent diffuse deposition of mercury particles throughout both lung fields. Swallowed mercury should be relatively harmless in small quantity but the high specific gravity and free flowing properties of elemental mercury allowed it to overcome the normal swallowing pathways--such that some of it passed into the bronchial tree instead of passing harmlessly through the gut. In that site its significant vapour pressure, together with its potential for oxidation to inorganic mercury--which may, in turn, be absorbed across the alveolar membrane, gives high potential for mercury poisoning.- - - - - - - - - - ranking = 1keywords = lung (Clic here for more details about this article) |
2/28. Acute mercury vapour poisoning in a shipyard worker--a case report.Acute mercury vapour poisoning is a serious, potentially fatal but fortunately rarely encountered problem. It is most commonly due to industrial accidents. The vapour is a direct respiratory tract irritant as well as a cell poison, exerting its greatest effects in the lungs, nervous system, kidneys and liver. We present a case of mercury vapour poisoning in a shipyard workers presenting as an acute chemical pneumonitis, which resolved with aggressive supportive therapy. Further investigations later revealed transient mild neuropsychiatric symptoms, and residual peripheral neuropathy. No chelation therapy was instituted. The detailed investigative work that led to the discovery of the source of mercury is also presented. This case alerts us to the potential hazard to shipyard workers who may work in ships previously carrying oil contaminated with mercury. There have been no previous reports of mercury poisoning in shipyard workers. A high index of suspicion leading to early diagnosis and institution of appropriate supportive measures in suspected cases can be life-saving.- - - - - - - - - - ranking = 1keywords = lung (Clic here for more details about this article) |
3/28. Elemental mercury poisoning in a family of seven.mercury poisoning in children is rare but may have devastating health consequences when exposure is unrecognized. Mercury occurs in three forms: elemental, inorganic, and organic. Elemental mercury (Hg(0)) vapor may become volatile following an accidental spill and may be readily absorbed from the lungs. The following case study describes how the poison center, health department, physicians, and others worked together to treat a family with long-term exposure to elemental mercury vapor in the home. Identification and prevention of this type of exposure in the community are discussed.- - - - - - - - - - ranking = 1keywords = lung (Clic here for more details about this article) |
4/28. Five years of follow-up after elemental mercury self-poisoning.A case of attempted suicide by injection of elemental mercury is described. Radiographs demonstrated the presence of widespread opacities of metallic mercury in both the lungs and the abdomen. During a 5-year follow-up, even though the patient had high concentrations of mercury in the urine and blood, only mild clinical symptoms and moderate carbon monoxide diffusing capacity reduction appeared. No biochemical evidence of damage to any organ was found.- - - - - - - - - - ranking = 1keywords = lung (Clic here for more details about this article) |
5/28. Mercury vapor inhalation from Chinese red (Cinnabar).INTRODUCTION: Acute inhalation of mercury fumes or vapors is a rare but frequently fatal cause of acute lung injury. This report describes a rare cause of mercury inhalation from Chinese red. CASE REPORT: An 87-year-old male inhaled the vapors from heating Chinese red (Cinnabar, mercury sulphide) intended to treat his foot ulceration. He subsequently developed acute lung injury (progressive dyspnea and acute respiratory failure) that was treated with mechanical ventilation. DMPS (2,3-Dimercapto-1-propanesulfonic acid) and penicillamine were used as chelating agents, and methylprednisolone pulse therapy was used to treat his pulmonary disease. Despite being extubated once, the patient eventually died from profound hypoxemia. CONCLUSION: A rare case of mercury intoxication was due to inappropriate use of an alternative medicine, Chinese red. This case serves as a reminder of the toxicity of the noxious gas from this substance and the importance of being familiar with alternative medicines.- - - - - - - - - - ranking = 6101.8928491838keywords = acute lung injury, lung injury, acute lung, lung, injury (Clic here for more details about this article) |
6/28. A patient with postoperative mercury contamination of the peritoneum.CASE REPORT: Peritoneal exposure to mercury has been rarely reported and long-term consequences of this type of exposure have not been documented. We report the clinical course of a patient who has survived almost eight years with a massive intraperitoneal load of mercury. She has suffered formication, pruritis, fatigue, irritiability, insomnia, alopecia, dizziness, a gait disturbance, loss of balance and multiple falls, abdominal pain, choking, and headaches. Two courses of chelation with dimercaptosuccinic acid using the standard protocol were undertaken, resulting in increased daily excretion, but without demonstrable objective or subjective benefit or lasting effect. She had multiple medical problems before the mercury intoxication, which complicates the attribution of all her problems to mercury intoxication. It is of particular interest that the patient survived and did not suffer any marked cognitive deterioration. She died in 2002 shortly after being diagnosed with lung cancer and declaring that she would fight it. Phasing out of mercury-weighted tubes is recommended.- - - - - - - - - - ranking = 1keywords = lung (Clic here for more details about this article) |
7/28. Elemental mercury-induced subcutaneous granuloma. A case report and review of the literature.The authors report a case of suicidal elemental mercury injection in the antecubital fossa, resulting in granuloma formation, which was treated with delayed resection. A 21-year-old man presented with a granuloma in the antecubital fossa after a suicide attempt by self-injection of elemental mercury. The patient was treated surgically with excision of the necrotic skin and granuloma under X-ray guidance, with good result. Despite the fact that human exposure to mercury has been ongoing for centuries, the deposition of metallic mercury into the skin and subcutaneous tissue, causing cutaneous granuloma formation is uncommon, with fewer than 100 reports presented in the dermatologic, toxicologic and general medical literature. On the contrary, there is a lack of reports of this soft-tissue injury in the orthopaedic literature.- - - - - - - - - - ranking = 0.73503376969681keywords = injury (Clic here for more details about this article) |
8/28. Poisoning from aspiration of elemental mercury.BACKGROUND: Mercury and mercury compounds (inorganic and organic) can cause acute or chronic poisoning. Acute poisonings, especially with inorganic salts, are widely described, but only sparse data are available on intoxication from oral elemental mercury. We report a case of elemental mercury ingestion followed by pulmonary aspiration of the elemental mercury. CASE REPORT: A 49-year-old woman intentionally ingested about 200 mL (2709 g) of elemental mercury and aspirated during gastric lavage. A chest radiograph demonstrated small radiodense droplets in the peripheral parts of both lung fields. Whole blood mercury concentrations were 330 microg/L on day 3, 457 microg/L on day 8, and 174 microg/L on day 17. The mercury concentration in a random urine sample was 231 microg/L on day 17. The patient was treated with oral d-penicillamine on the 25th-32nd day after ingestion. A hair sample taken from near the scalp on day 31 had a mercury concentration of 1.38 microg/g. The patient demonstrated impaired memory and disturbances in verbal-logical thinking. At 6 months, she had improved clinically; her whole blood mercury concentration was 16.4 microg/L and the mercury concentration in a random urine sample was 141 microg/L. CONCLUSIONS: In this case, systemic absorption of elemental mercury, occured after the ingestion of a massive dose of elemental mercury complicated by pulmonary aspiration.- - - - - - - - - - ranking = 1keywords = lung (Clic here for more details about this article) |
9/28. Cutaneous mercury granuloma.mercury poisoning arising from cutaneous mercury deposition is highly unusual. The diagnosis is difficult to make when no history of a penetrating injury is given. We report such a case and discuss investigation and management. Other cutaneous manifestations of mercury exposure are outlined.- - - - - - - - - - ranking = 0.73503376969681keywords = injury (Clic here for more details about this article) |
10/28. Respiratory failure and death following acute inhalation of mercury vapor. A clinical and histologic perspective.A family of four was exposed to toxic levels of mercury vapor while attempting to extract silver from mercury amalgam. All four suffered respiratory failure and subsequent death despite chelation therapy with dimercaprol. Histologic findings at autopsy were similar in all four cases demonstrating a progression of acute lung injury that appeared related to postexposure day survival. There were no clinical signs of extrapulmonary manifestations despite toxic serum mercury levels. Although serum mercury levels decreased in response to the mercury chelating agent dimercaprol, serum levels remained in the toxic range and no clinical response was observed. Acute inhalational exposure to high concentrations of mercury vapor causes pneumonitis that can lead to respiratory failure and death. This continues to be a health hazard in both the workplace and the home environment.- - - - - - - - - - ranking = 3050.9464245919keywords = acute lung injury, lung injury, acute lung, lung, injury (Clic here for more details about this article) |
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