From Sphygmomanometer to Lungs: Unveiling Mercury Poisoning in Emergency Department

TL;DR

A 27-year-old man who injected mercury intravenously developed severe symptoms and later died from toxic epidermal necrolysis despite treatment.

Contribution

This case report highlights the rare but fatal consequences of intravenous mercury poisoning and the potential for severe complications like TEN.

Findings

Intravenous mercury poisoning can lead to acute symptoms like breathlessness and fever.

Toxic epidermal necrolysis was diagnosed five days after initial treatment and proved fatal.

Despite chelation therapy and supportive care, the patient succumbed to complications.

Abstract

Mercury, a ubiquitous heavy metal, poses a significant threat to human health. Intravenous mercury poisoning is an uncommon but critical medical emergency. The nature and severity of its toxic effects depend on the form of mercury encountered: elemental, inorganic, or organic. It can affect almost all organ systems in the body. Chelating agents are the primary treatment for symptomatic mercury poisoning. This case report is about a 27-year-old male patient who presented to the emergency department with an alleged history of intravenous injection of mercury as an attempt at suicide, followed by breathlessness, chest pain, vomiting, and high-grade fever. He was managed with chelating therapy, non-invasive ventilation, and other supportive measures and was discharged home. After five days of discharge, he presented with fever and rashes and was diagnosed with toxic epidermal necrolysis (TEN). In spite of all aggressive management, he succumbed to death after four days of re-admission. Early intervention can significantly improve the chances of recovery. However, even with successful treatment, some individuals may experience long-term complications.

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