Citation

Beasley DMG, Schep LJ, Slaughter RJ, Temple WA, Michel JM. J. Med. Toxicol. 2014; 10(1): 40-44.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s13181-013-0311-1

PMID

unavailable

Abstract

INTRODUCTION: Mercuric chloride poisoning is rare yet potentially life-threatening. We report a case of poisoning with a potentially significant amount of mercuric chloride which responded to aggressive management. Case Report: A 19-year-old female presented to the Emergency Department with nausea, abdominal discomfort, vomiting of blood-stained fluid, and diarrhea following suicidal ingestion of 2-4 g of mercuric chloride powder. An abdominal radiograph showed radio-opaque material within the gastric antrum and the patient's initial blood mercury concentration was 17.9 μmol/L (or 3.58 mg/L) at 3 h post-ingestion. Given the potential toxicity of inorganic mercury, the patient was admitted to the intensive care unit and chelation with dimercaprol was undertaken. Further clinical effects included mild hemodynamic instability, acidosis, hypokalemia, leukocytosis, and fever. The patient's symptoms began to improve 48 h after admission and resolved fully within a week.

DISCUSSION: Mercuric chloride has an estimated human fatal dose of between 1 and 4 g. Despite a reported ingestion of a potentially lethal dose and a high blood concentration, this patient experienced mild to moderate poisoning only and she responded to early and appropriate intervention. Mercuric chloride can produce a range of toxic effects including corrosive injury, severe gastrointestinal disturbances, acute renal failure, circulatory collapse, and eventual death. Treatment includes close observation and aggressive supportive care along with chelation, preferably with 2,3-dimercapto-1-propane sulfonate or 2,3-meso-dimercaptosuccinic acid. © 2013 American College of Medical Toxicology.

Language: en

Keywords

Humans; Adult; Female; adult; human; female; Young Adult; Treatment Outcome; Suicide, Attempted; case report; toxicity; suicide attempt; treatment outcome; Case report; intoxication; article; vomiting; tachycardia; diarrhea; nausea; fever; QT prolongation; blood; chelation therapy; dimercaprol; potassium; urea; lethal dose; mercury; dyspnea; coughing; electrocardiography; Mercury; abdominal radiography; infusion fluid; leukocytosis; thorax radiography; clindamycin; chelating agent; Chelating Agents; Mercury Poisoning; Mercury poisoning; hypokalemia; abdominal discomfort; Injections, Intramuscular; hypoxemia; chemistry; intramuscular drug administration; Chelation Therapy; rectum hemorrhage; acidosis; young adult; antagonists and inhibitors; atelectasis; Dimercaprol; mercuric chloride; Mercuric Chloride; T wave inversion; dyes, reagents, indicators, markers and buffers; Indicators and Reagents; Chelation; Inorganic mercury; Mercuric chloride; mercuric chloride poisoning