Elemental Mercury Embolism

A 32-year-old woman presented with dry cough and was found to have numerous tiny bilateral intrathoracic metallic densities on initial chest radiography. CT of the chest, abdomen, and pelvis showed metallic spherules with systemic distribution, including both lungs, the myocardium, liver, both kidneys, large and small bowel, and sacral spinal canal. Elevated 24-hour urine mercury levels confirmed mercury poisoning from indigenous infertility medication. After medication cessation, mercury levels normalized at 2 months. This case shows the characteristic diagnostic imaging appearance of systemic elemental mercury deposition, highlighting the clinical value of recognizing this entity.