Intravenous mercury injection and ingestion: clinical manifestations and management

J Toxicol Clin Toxicol. 2001;39(7):733-8. doi: 10.1081/clt-100108515.


Background: Mercury is a complex toxin with clinical manifestations determined by the chemical form, route, dose, and acuity of the exposure. Parenteral injection of elemental mercury remains uncommon.

Case report: A 40-year-old male injected 3 mL of elemental mercury intravenously and ingested 3 mL as a suicide attempt. Within 24 hours, he became dyspneic, febrile, tachycardic, and voiced mild gastrointestinal complaints. Chest X-ray revealed scattered pulmonary infiltrates and embolized mercury bilaterally. A ventilation/perfusion scan demonstrated ventilation/ perfusion deficits. Additionally, his renal function declined, as manifest by minor elevations in blood urea nitrogen and creatinine and decreased urine output. Pulmonary therapy, intravenous hydration, and chelation using 2,3-dimercaptoscuccinic acid (DMSA/Succimer) were started. Over the next 36 hours, the patient's pulmonary and renal functions improved. Temperature and heart rate subsequently normalized, and symptoms at discharge were mild exertional dyspnea.

Discussion: Liquid mercury injected intravenously embolizes to the pulmonary vasculature and perhaps vessels in other organs such as heart and kidney. In-situ oxidation to inorganic mercury, which is directly toxic to a variety of tissues, may help explain the multisystem involvement.

Conclusion: Significant pulmonary dysfunction accompanied by radiographically demonstrated mercury emboli and temporary abnormalities in several organs improved shortly after initiation of chelation. The impact of chelation on long-term outcome of parenteral mercury exposure remains uncharacterized.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Adult
  • Chelation Therapy
  • Fluid Therapy
  • Humans
  • Injections, Intravenous
  • Kidney / drug effects
  • Kidney / physiopathology
  • Lung / diagnostic imaging
  • Lung / drug effects*
  • Male
  • Mercury / administration & dosage
  • Mercury / adverse effects*
  • Mercury Poisoning / diagnostic imaging
  • Mercury Poisoning / etiology*
  • Mercury Poisoning / therapy
  • Pulmonary Embolism / chemically induced*
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / therapy
  • Pulmonary Ventilation
  • Radiography, Thoracic
  • Respiration / drug effects*
  • Succimer / therapeutic use
  • Suicide, Attempted


  • Succimer
  • Mercury