Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 38-42: Mercury Poisoning + Key Features Download Section PDF Listen +++ ++ Acute mercury poisoning usually occurs by Ingestion of inorganic mercuric salts Inhalation of metallic mercury vapor Some organic mercury compounds (eg, dimethyl mercury) are extremely toxic by any route Other organic mercury compounds in fish (eg, ethyl mercury) can lead to elevated mercury levels with long-term intake + Clinical Findings Download Section PDF Listen +++ ++ Mercury salts Metallic taste Burning sensation in the throat Discoloration and edema of oral mucous membranes Abdominal pain Vomiting Bloody diarrhea Shock Acute kidney injury from nephrotoxicity Inhalation of high concentrations of metallic mercury vapor may cause acute fulminant chemical pneumonia Chronic mercury poisoning causes Weakness Ataxia Intention tremors Irritability Depression Exposure to alkyl (organic) mercury derivatives from highly contaminated fish or fungicides used on seeds has caused Ataxia Tremors Convulsions Catastrophic birth defects + Treatment Download Section PDF Listen +++ +++ ACUTE POISONING ++ No specific treatment exists for mercury vapor pneumonitis Ingestion of liquid metallic mercury: small amounts usually pass unabsorbed through the GI tract Treat oliguria and anuria if they occur to maintain urinary output For acute ingestion of mercuric salts Remove ingestion by gastric lavage Administer activated charcoal 60–100 g in aqueous slurry orally or via gastric tube (unproved efficacy) Give dimercaprol (British anti-Lewisite, BAL) at once, 10% solution in oil, 3–5 mg/kg intramuscularly every 4–6 hours for 2 days Consider succimer (DMSA), 10 mg/kg orally every 8 hours for 5 days and then every 12 hours for 2 weeks, unless patient has severe gastroenteritis Unithiol (DMPS) can be given orally or parenterally but is not commonly available in the United States; it can be obtained from some compounding pharmacies Contact a poison control center or medical toxicologist for assistance +++ CHRONIC POISONING ++ Remove from exposure Neurologic toxicity is not considered reversible with chelation, although some recommend a trial of succimer or unithiol