Acute mercury poisoning

Permeated

Step 1: View clinicals

A 15-year-old boy presents with a high fever, an intermittent non-productive cough, and dyspnea for one day, along with a generalized itchy rash for two days. On close questioning, he reveals that he has been performing chemistry experiments for the last several days, on a sample of mercury he obtained from a broken thermometer. He lives with his parents and younger brother, all of whom are currently in good health. His medical history is unremarkable with no history of allergies.


Step 2: Order all relevant investigations

Complete blood count

WBC: 4,900/mm3 (4,500-12,000) Hb: 13.1 g/dL (13-16) Plt: 198,000/mm3 (150,000-400,000)

Renal function tests

Blood urea: 75 mg/dL (10-50) Serum creatinine: 1.6 mg/dL (0.4-1.5)

Serum mercury levels

Serum mercury: 79 μg/L (0.6-10)

Chest X-Ray

The chest X-ray shows bilateral non-homogenous basal opacities, with a few nonspecific nodular lesions.


Step 3: Select appropriate management

Antihistamines
Bronchodilators
ICU care
DMPS chelation


Score: ★★☆