Case Presentation A 36-year-old woman presented to the ED with a three-day history of abdominal pain, diarrhea and fever. One week ago her daughter had brought mercury in the liquid form from the school without permission from her teacher. She had played with the mercury, and then put it on the heating stove and watched its vaporization. Meanwhile, her mother breast-fed her 14-month old sister. 24 hours after this event her baby got fever Inhibitors,research,lifescience,medical and died before admission to the hospital, without any specific diagnosis. The autopsy report disclosed a suspected mercury poisoning which might have led to
cardiorespiratory collapse resulting in death of the infant. On examination, her blood pressure was 134/87 mmHg; temperature, 40.2°C; heart rate 105 bpm and Inhibitors,research,lifescience,medical regular; respiration, 18 bpm; O2 saturation, 96% with pulse oximetry at room temperature. The patient had no past medical history.
Her fever relieved after administration of 1 gr paracetamol given via intravenous route, while arterial oxygen saturation rose to 98% with supplemental oxygen. Nothing was remarkable in her head-neck, respiratory, cardiovascular, or abdominal examinations. Neurological examination did not reveal any tremor, paresthesia, ataxia, spasticity, hearing and vision loss. Neuropsychiatric abnormalities were not identified. Complete blood count, urinalysis, sodium, potassium, blood urea nitrogen (BUN), Inhibitors,research,lifescience,medical creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin levels were within normal ranges. Chest X-ray and cranial computed tomography revealed no findings of disease. As serine or urinary mercury levels could not be tested in the Inhibitors,research,lifescience,medical city, symptomatic chelation treatment with N-acetyl cysteine (NAC) was instituted with regard to presumptive diagnosis and history. At the 7th day of admission she was discharged without
any sequelae or complaint. In the same day, blood was drawn and sent for mercury levels which turned out to be 30 Inhibitors,research,lifescience,medical μg/dL (normal range: 0 – 10 μg/dL in accord with the hospital laboratory reference). Her symptoms guided the treatment and her laboratory results took three days to be officially reported. A week after the discharge the patient revisited the ED due to recurrent abdominal pain. Physical examination and laboratory test results were unremarkable and she was discharged after 24-hour observation. Follow-up was scheduled for one week later. why In follow-up visit the patient was asymptomatic without any clinical finding. Therefore, NAC treatment was selleck chemical terminated after 14 treatment days. The other children did not exhibit any manifestations of the disease. Conclusion Children are always attracted to elemental mercury with its bright gray appearance [2]. The compound has a short half-life in the blood due to rapid distribution into body compartments. Half life in the body is only two months. Almost all of the absorbed amount is excreted via urination [3].
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