Acute Mercury Vapor Poisoning

Acute mercury poisoning is commonly caused by accidental ingestion of soluble mercurial compounds. The clinical manifestations are an accurate portrayal of the severe ulcerative and necrotizing inflammation of the entire gastrointestinal tract. The excretory organs, the central nervous system, and other internal organs are secondarily involved. More rarely, acute poisoning may result from the inhalation of mercury vapor. In this event, the respiratory epithelium, being the primary site of contact, bears the brunt of the injury, and respiratory symptoms dominate the clinical picture. The central nervous system, kidneys, liver, and gastrointestinal tract may also be affected, usually to a mild degree at most, through absorption in the respiratory tract. Two papers reporting acute mercury vapor poisoning as a result of industrial mishaps (2, 5) and 2 reporting domestic accidents (1, 3) were found in a brief survey of the literature. The common features are (a) the inhalation of mercurial fumes caused by heating of metallic mercury and (b) the prominence of respiratory symptoms. Radiographic findings are included in the accounts of the domestic accidents. One of these patients was a four-month-old infant who succumbed to the intoxication in three days (1). The chest film (not published) showed (a) circumscribed opacities in both upper lung fields interpreted as atelectasis; (b) minor infiltration at right base; (c) diffuse compensatory emphysema; (d) left-sided pneumothorax. A postmortem examination was not performed. In the other patient, a twenty-nine-year-old man, the chest film showed “bilateral broncho-pulmonary abnormalities probably indicative of aspiration and exudative type bronchitis” (3). In this instance recovery ensued after ten days hospitalization. The radiographic evidence of chemical pneumonitis had completely resolved in fifteen days. A family of four, a nineteen-year-old mother and her three children, thirty months, twenty months, and four months of age, suffering from acute mercury vapor poisoning, which ended fatally for all the children, has been observed in our hospital. The radiographic findings, not fully described in the case report published elsewhere (4), and their correlation with the postmortem findings are presented in this communication. Clinical History The History of the Tragedy: A Negro family of four—a nineteen-year-old mother and her three children, thirty months, twenty months, and four months—lived in a two-room apartment. The family was apparently in good health before their exposure to mercury fumes on the night of Feb. 28, 1957. The father was away from home at the time. The illness seized all four patients on the same night and was characterized by severe respiratory distress, cough, diarrhea, and mental depression.