Different mercury compounds are used as antiseptic and diuretic in medicine [1]. It is also an ingredient in the drug Thiomersal which is used to prevent contamination of vaccines. Acute inhalations of mercury vapors can cause pneumonia, adult respiratory distress syndrome, progressive pulmonary fibrosis and death. Also elemental (metallic) mercury can readily pass to systemic circulation via alveoli present in mercury Inhibitors,research,lifescience,medical vapor or directly through the skin. It is also known to pass directly from nursing mothers to infants via breast milk [4]. Predominance of gastrointestinal symptoms and historical findings
suggest intoxication with elemental mercury in the present case. All kinds of neurological findings can be seen in chronic mercury exposure. Some effects of high dose mercury inhalation are shown on Table Table11[4,5]. A recently published recommendation guideline stresses that “if the elemental mercury was recently heated (e.g., from stove top, oven, furnace) in an enclosed area, all people Inhibitors,research,lifescience,medical within the Inhibitors,research,lifescience,medical exposure area should be evaluated at a healthcare facility due to the high risk of toxicity (Grade C)” [1]. Table 1 Effects of high dose mercury inhalation [5]. Findings in history played a critical role in the diagnosis in
the present case. Inquiry for additional acid, alkali, arsenic, phosphorus or iron ingestion did not yield any suspicious finding. History of exposure to mercury, gastrointestinal symptoms and suspicious death of breast fed Inhibitors,research,lifescience,medical baby led us to the presumptive diagnosis of acute mercury poisoning. It can be postulated that in the present case neurotoxicity was prevented by NAC treatment which was instituted empirically based on clinical symptoms and history although blood and urine mercury levels were not determined at the time of admission. Because brain maturation was not completed in young children and fetuses even a small exposure can be fatal [6]. Death of the previously healthy baby in 24 hours prompts consideration of necrotizing bronchitis,
pneumonia or respiratory Inhibitors,research,lifescience,medical distress syndrome [7]. Inhalation of mercury by the baby can be thought to be the main reason of death. whatever Initial treatment is keeping the patient away from the environment and toxic agents. NAC is used for chelation of mercury, due to lack of other treatment see more options. Basically it binds mercury by its cystein groups [1]. The chelating drugs with worldwide application are dimercaprol (BAL), dimercaprosuccinic acid (DMSA), 2,3-Dimercapropropane-1-sulphonate (DMPS) British Anti Lewisite (BAL) (2.5 mg/kg) is also commonly used in the treatment [1,8]. This case report emphasizes the importance of public education on poisoning and specifically, potential hazards of mercury for preventive community health. Training is recommended for school children and teachers on poisoning with heavy metal compounds.