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.