Mercury (Hg) is one of the most widespread pollutants that pose serious threats to public health and the environment. People are inevitably exposed to Hg via different routes, such as respiration, dermal contact, drinking or diet. Hg poisoning could cause gingivitis, inflammation, vomiting and diarrhea, respiratory distress or even death. Especially during the developmental stage, there is considerable harm to the brain development of young children, causing serious symptoms such as intellectual disability and motor impairments, and delayed neural development. Therefore, it's of great significance to develop a specific, quick, practical and labor-saving assay for monitoring Hg2+. Herein, a mitochondria-targeted dual (excitation 700 nm and emission 728 nm) near-infrared (NIR) fluorescent probe JZ-1 was synthesized to detect Hg2+, which is a turn-on fluorescent probe designed based on the rhodamine fluorophore thiolactone, with advantages of swift response, great selectivity, and robust anti-interference capability. Cell fluorescence imaging results showed that JZ-1 could selectively target mitochondria in HeLa cells and monitor exogenous Hg2+. More importantly, JZ-1 has been successfully used to monitor gastrointestinal damage of acute mercury poisoning in a drug-induced mouse model, which provided a great method for sensing Hg species in living subjects, as well as for prenatal diagnosis.
Fluorescent Dyes , Mercury Poisoning , Mercury , Mitochondria , Fluorescent Dyes/chemistry , Mitochondria/drug effects , Humans , Animals , HeLa Cells , Mercury Poisoning/diagnostic imaging , Mercury/toxicity , Optical Imaging , Mice , Gastrointestinal Tract/drug effects , Gastrointestinal Tract/diagnostic imaging , Gastrointestinal Tract/metabolism , Female , Gastrointestinal Diseases/diagnostic imaging , Gastrointestinal Diseases/chemically induced , Rhodamines/chemistry , Rhodamines/toxicity
INTRODUCTION: Metallic mercury poisoning through intravenous injection is rare, especially as part of a suicide attempt. Diagnosis and treatment of the disease are challenging as clinical features are not specific. MATERIAL AND METODS: A 41-year-old male presented with dyspnea, fatigue, loss of weight, and loss of appetite over two months. Routine radiological examination by chest X-ray and CT showed randomly distributed high density opacities with Hounsfield units (HU) around 500 HU all over the body. The diagnosis was then confirmed with a urinary mercury concentration of > 1000 mcg/24 h. RESULTS: The patient's clinical condition was getting worse in spite of chelation therapy and hemodialysis. The patient eventually died because of respiratory failure. CONCLUSION: Early diagnosis and appropriate treatment are critical for intravenous mercury poisoning especially because there are no specific signs or symptoms. There should be a high level of suspicion in drug abusers. Treatment should involve the combined use of chelating agents and other treatments such as hemodialysis and plasma exchange in advanced clinical settings.
Chelating Agents/therapeutic use , Mercury Poisoning/diagnostic imaging , Mercury Poisoning/drug therapy , Respiratory Insufficiency/chemically induced , Adult , Fatal Outcome , Humans , Male , Pulmonary Embolism/chemically induced
Mercury toxicity is commonly associated with vapour inhalation or oral ingestion, for which there exist definite treatment options.Intravenous mercury injection is rarely seen, with few documented cases. Treatment strategies are not clearly defined for such cases,although a few options do show benefit. This case report describes a 29-year-old man suffering from bipolar disorder, who presentedfollowing self-inflicted intravenous injection of mercury. Clinical and radiographic features, possible adverse clinical sequelae in preexistingmental illness and further complications are discussed, as well as possible treatment strategies in light of relevant literature.
Acute Kidney Injury/chemically induced , Blood Vessels/diagnostic imaging , Mercury Poisoning/diagnostic imaging , Abdomen/diagnostic imaging , Adult , Bipolar Disorder/psychology , Chelating Agents/therapeutic use , Forearm/diagnostic imaging , Humans , Injections, Intravenous , Male , Mercury Poisoning/blood , Mercury Poisoning/drug therapy , Penicillamine/therapeutic use , Radiography , Radiography, Thoracic , Suicide, Attempted/psychology
Se han reportado en la literatura pocos casos de intoxicación por mercurio por administración en tejidos blandos. No se cuenta con suficiente evidencia acerca del manejo con terapia quelante en este tipo de intoxicación. Se reporta el caso de una mujer de 34 años con antecedente psiquiátrico la cual se administró mercurio intramuscular en fosa cubital izquierda con fines autolíticos. Acudió al servicio de urgencias 24 horas posteriores a su administración, el motivo principal fue el dolor intenso en la zona y la presencia de edema, sin efectos sistémicos. La radiografía mostró depósitos metálicos en 1/3 de brazo, localizados en músculo, y que migraron a través de la fascia hacia 2/3 del antebrazo. La placa de tórax no mostró alteraciones. Fue intervenida quirúrgicamente en 3 ocasiones extrayendo mínimas cantidades de mercurio. La paciente fue manejada con antibióticos por presencia de celulitis. Un mes después presentó temblor mercurial, razón por la cual se tomaron muestras de sangre y orina para la determinación de mercurio, el cual resulto elevado en ambas muestras, por lo que se le administró terapia quelante con D-penicilamina.
There are just a few cases of mercury toxicity after administration in soft tissue, reported in the literature. There is insufficient evidence about the management with chelation therapy in this type of poisoning. We report the case of a 34 year-old woman with a psychiatric history who administered herself a mercury injection into de muscle in the left cubital fossa, referred as a suicide attempt. She came to the emergency department 24 hours after administration; the main reason was the intense pain in the area and the presence of edema, with no systemic effects. Radiography showed metallic deposits in 1/3 arm, located in muscle, which moved through the fascia to 2/3 of the forearm. Chest radiography was normal. She underwent surgery trhee times extracting trace amounts of mercury. The patient was managed with antibiotics by the presence of cellulite. One month later she had tremor mercuralis, so a blood and urine samples were sent to the laboratory in order to determinate mercury levels, which resulted high in both fluids, therefore chelation therapy with D-penicillamine was administered.
Humans , Female , Adult , Mercury Poisoning/diagnostic imaging , Mercury Poisoning/drug therapy , Mercury/toxicity , Chelation Therapy/statistics & numerical data , Mercury Poisoning/surgery , Mercury Poisoning/urine
INTRODUCTION: Significant exposure to elemental mercury can occur if a mercury-weighted medical device is damaged during use. We report a case of an elemental mercury spill into the peritoneum of a patient undergoing laparoscopic gastric bypass surgery. CASE REPORT: A 64-year-old man with multiple comorbidities underwent an elective Roux-en-Y gastric bypass procedure for the treatment of morbid obesity. A mercury-weighted esophageal bougie was inadvertently used during construction of the anastomosis. A suture placed through the distal tip of the device caused elemental mercury to leak into the peritoneum. Two days later, the patient underwent another surgical procedure for removal of the mercury. Intermittent air measurements taken from the laparoscope exhaust showed a peak intraperitoneal mercury concentration of 98,169 ng/m³. Blood mercury levels peaked at 146 µg/L on day 22 after the exposure, and urine mercury concentrations peaked on day 43 at 227 µg/L. The patient had no evidence of acute toxicity, but he was found to have proteinuria on follow-up evaluation. DISCUSSION: Patients can be exposed inadvertently to toxic amounts of elemental mercury when the integrity of medical devices is compromised. We encourage hospitals to discontinue the use of devices that contain mercury. Effective alternatives that do not pose exposure risks to patients or health care workers are readily available.
Dilatation/instrumentation , Equipment Failure , Gastric Bypass/instrumentation , Iatrogenic Disease , Intraoperative Complications/surgery , Medical Errors/adverse effects , Mercury Poisoning/surgery , Air/analysis , Dilatation/adverse effects , Gastric Bypass/adverse effects , Humans , Iatrogenic Disease/prevention & control , Intraoperative Complications/diagnostic imaging , Intraoperative Complications/etiology , Intraoperative Complications/metabolism , Male , Medical Errors/prevention & control , Mercury/analysis , Mercury/blood , Mercury/urine , Mercury Poisoning/diagnostic imaging , Mercury Poisoning/etiology , Mercury Poisoning/metabolism , Middle Aged , Obesity, Morbid/surgery , Peritoneal Cavity/diagnostic imaging , Peritoneal Cavity/surgery , Proteinuria/chemically induced , Tomography, X-Ray Computed , Treatment Outcome
This case discusses a gentleman who presented to the medical team after ingesting mercury liquid. We discuss the assessment, management and different types of mercury poisoning.
Appendix/metabolism , Mercury Poisoning , Mercury/metabolism , Abdominal Pain/diagnostic imaging , Abdominal Pain/etiology , Abdominal Pain/metabolism , Aged , Appendix/diagnostic imaging , Appendix/pathology , Humans , Laxatives/therapeutic use , Male , Mercury Poisoning/complications , Mercury Poisoning/diagnostic imaging , Mercury Poisoning/drug therapy , Mercury Poisoning/pathology , Radiography, Abdominal , Suicide, Attempted
Heart/diagnostic imaging , Mercury Poisoning/diagnosis , Self-Injurious Behavior/diagnosis , Heart/drug effects , Humans , Injections, Intravenous/adverse effects , Male , Mercury Poisoning/diagnostic imaging , Mercury Poisoning/etiology , Mercury Poisoning/pathology , Myocardium/pathology , Occupational Diseases/diagnosis , Occupational Diseases/diagnostic imaging , Occupational Diseases/pathology , Radiography , Recycling , Self-Injurious Behavior/diagnostic imaging , Self-Injurious Behavior/etiology
Mercury Poisoning/diagnostic imaging , Adult , Delusions/complications , Diagnosis, Differential , Humans , Lung Diseases/complications , Lung Diseases/diagnostic imaging , Lung Diseases/etiology , Male , Mercury Poisoning/complications , Mercury Poisoning/etiology , Radiography , Substance Abuse, Intravenous/complications
Mercury is known to be associated with both acute and chronic poisoning. A 36-year-old man intentionally ingested mercuric chloride (HgCl(2)) and died within 24h. Post-mortem CT images showed oral, esophageal and gastric wall hyperdense "staining". On toxicological analysis, the blood concentration of mercury was measured at 25.5mg/L; a figure far higher than reported lethal levels. Autopsy was not performed in order to prevent potential inhalation of mercury vapor by pathology staff.
Mercuric Chloride/poisoning , Mercury Poisoning/diagnostic imaging , Postmortem Changes , Suicide , Tomography, X-Ray Computed , Adult , Humans , Male , Mercury Poisoning/physiopathology
Mercury Poisoning/diagnostic imaging , Mercury/administration & dosage , Mercury/toxicity , Self-Injurious Behavior/diagnostic imaging , Abdominal Wall/surgery , Adult , Alcoholism/complications , Arm/blood supply , Bipolar Disorder/complications , Debridement , Foreign Bodies/diagnostic imaging , Foreign Bodies/surgery , Humans , Injections, Intravenous , Injections, Subcutaneous , Ligation , Male , Mercury Poisoning/surgery , Phlebography , Pulmonary Embolism/chemically induced , Pulmonary Embolism/surgery , Subcutaneous Tissue/drug effects , Subcutaneous Tissue/surgery , Suture Techniques , Veins/surgery
BACKGROUND: Intravenous injection of elemental mercury (Hg) is rare and considered relatively harmless. Treatment recommendations vary and the effectiveness of chelation therapy is controversial. CASE REPORT: A 27-year-old man intravenously injected 1.5 mL of elemental Hg. Within 12 hours he became febrile, tachycardic and dyspneic. Physical examination was unremarkable. X-rays showed scattered radiodense deposits in the lung, heart, intestinal wall, liver and kidney. The serum Hg level on admission was 172 microg/L and peaked on day 6 at 274 microg/L. Cumulative renal elimination during a five day oral treatment period with 2,3-dimercaptopropane-1-sulfonate (DMPS) and meso-2,3-dimercaptosuccinic acid (DMSA) was 8 mg and 3 mg, respectively. CONCLUSION: Although urinary excretion could be enhanced during chelation therapy, Hg deposits in organs resulted in negligible elimination of mercury compared to the exposed dose.
Chelating Agents/therapeutic use , Mercury Poisoning/drug therapy , Succimer/therapeutic use , Unithiol/therapeutic use , Adult , Colon/diagnostic imaging , Colon/metabolism , Heart Ventricles/diagnostic imaging , Heart Ventricles/metabolism , Humans , Injections, Intravenous , Kidney/diagnostic imaging , Kidney/metabolism , Liver/diagnostic imaging , Liver/metabolism , Lung/diagnostic imaging , Lung/metabolism , Male , Mercury/pharmacokinetics , Mercury Poisoning/diagnostic imaging , Mercury Poisoning/metabolism , Radiography , Suicide, Attempted