Mercury Toxicity Differential Diagnoses

  • Author: David A Olson, MD; Chief Editor: Tarakad S Ramachandran, MBBS, FRCP(C), FACP   more...
 
Updated: Dec 7, 2011
 
 

Diagnostic Considerations

Mercury poisoning can be misdiagnosed because of the insidious onset and nonspecific signs and symptoms. Without a complete history, mercury toxicity, especially in elderly individuals, can be misdiagnosed as Parkinson disease, senile dementia, metabolic encephalopathy, depression, or Alzheimer disease.

Testing for mercury exposure is warranted if examination findings are consistent with Minamata disease, particularly if the disease occurs in multiple patients without clear etiology. This is especially true in populations in whom fish is a major part of their diet.

Consider mercury intoxication in the differential diagnosis when unexplained neuropsychiatric disturbances are coupled with renal abnormalities.

Conditions to consider in the differential diagnosis of mercury toxicity include the following:

  • Adverse effects of therapeutic medication (eg, lithium, theophylline, phenytoin)
  • Alzheimer disease
  • Cerebellar degenerative disease or tumor
  • Delayed neuropsychiatric sequela of carbon monoxide poisoning
  • Ethanol or sedative hypnotic drug withdrawal
  • Lacunar infarction
  • Metabolic encephalopathy
  • Parkinson disease
  • Senile dementia

Conditions to consider in the differential diagnosis of inorganic mercury toxicity (mercury salts) include the following:

  • Acid ingestion
  • Alkali ingestion
  • Arsenic toxicity
  • Iron toxicity
  • Phosphorus toxicity
  • Similar to the causes of acute gastroenteritis

Conditions to consider in the differential diagnosis of organic mercury toxicity in neonates include the following:

  • Cerebral palsy
  • Intrauterine hypoxia
  • Teratogenic effects in the embryo

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

David A Olson, MD  Clinical Neurologist, Dekalb Neurology Associates, Decatur, Georgia

David A Olson, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Chief Editor

Tarakad S Ramachandran, MBBS, FRCP(C), FACP  Professor of Neurology, Clinical Professor of Medicine, Clinical Professor of Family Medicine, Clinical Professor of Neurosurgery, State University of New York Upstate Medical University; Chair, Department of Neurology, Crouse Irving Memorial Hospital

Tarakad S Ramachandran, MBBS, FRCP(C), FACP is a member of the following medical societies: American Academy of Neurology, American Academy of Pain Medicine, American College of Forensic Examiners, American College of International Physicians, American College of Managed Care Medicine, American College of Physicians, American Heart Association, American Stroke Association, Royal College of Physicians, Royal College of Physicians and Surgeons of Canada, Royal College of Surgeons of England, and Royal Society of Medicine

Disclosure: Abbott Labs None None; Teva Marion None None; Boeringer-Ingelheim Honoraria Speaking and teaching

Additional Contributors

Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, University Hospitals, Case Medical Center

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York AcademyofSciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Timothy E Corden, MD Associate Professor of Pediatrics, Co-Director, Policy Core, Injury Research Center, Medical College of Wisconsin; Associate Director, PICU, Children's Hospital of Wisconsin

Timothy E Corden, MD is a member of the following medical societies: American Academy of Pediatrics, Phi Beta Kappa, Society of Critical Care Medicine, and Wisconsin Medical Society

Disclosure: Nothing to disclose.

Barry M Diner, MD, MPH, FACEP Assistant Clinical Professor, Department of Emergency Medicine, Emory University School of Medicine; Attending Physician, St Luke's Episcopal Hospital, Houston, Texas

Barry M Diner, MD, MPH, FACEP is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Fred Harchelroad, MD, FACMT, FAAEM, FACEP Chair, Department of Emergency Medicine, Director of Medical Toxicology, Allegheny General Hospital; Associate Professor, Department of Emergency Medicine, Drexel University College of Medicine

Disclosure: Nothing to disclose.

Michael E Mullins, MD Assistant Professor, Department of Emergency Medicine, Washington University School of Medicine

Michael E Mullins, MD is a member of the following medical societies: American Academy of Clinical Toxicology and American College of Emergency Physicians

Disclosure: Johnson & Johnson stock ownership None; Savient Pharmaceuticals stock ownership None

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

David K Tan, MD, EMT-T, FAAEM Assistant Professor and Chief, EMS Section, Division of Emergency Medicine, Medical Director, Washington University EMS, Washington University in St Louis School of Medicine

David K Tan, MD, EMT-T, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and National Association of EMS Physicians

Disclosure: Nothing to disclose.

Asim Tarabar, MD Assistant Professor, Director, Medical Toxicology, Department of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital

Disclosure: Nothing to disclose.

Jeffrey R Tucker, MD Assistant Professor, Department of Pediatrics, Division of Emergency Medicine, University of Connecticut and Connecticut Children's Medical Center

Disclosure: Merck Salary Employment

John T VanDeVoort, PharmD Regional Director of Pharmacy, Sacred Heart & St. Joseph's Hospitals

John T VanDeVoort, PharmD is a member of the following medical societies: American Society of Health-System Pharmacists

Disclosure: Nothing to disclose.

Mary L Windle, PharmD, Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

References

  1. Charcot JM. Clinical lectures of diseases of the nervous system. The Landmark Library of Neurology and Neurosurgery. 1994;186.

  2. Wilson SAK. Neurology. The Landmark Library of Neurology and Neurosurgery. 1994;739-740.

  3. Harada M. Minamata disease: methylmercury poisoning in Japan caused by environmental pollution. Crit Rev Toxicol. 1995;25(1):1-24. [Medline].

  4. Takeuchi T, Eto K, Kinjo Y, Tokunaga H. Human brain disturbance by methylmercury poisoning, focusing on the long-term effect on brain weight. Neurotoxicology. Spring 1996;17(1):187-90. [Medline].

  5. Vahter ME, Mottet NK, Friberg LT, Lind SB, Charleston JS, Burbacher TM. Demethylation of methyl mercury in different brain sites of Macaca fascicularis monkeys during long-term subclinical methyl mercury exposure. Toxicol Appl Pharmacol. Oct 1995;134(2):273-84. [Medline].

  6. Carvalho CM, Chew EH, Hashemy SI, Lu J, Holmgren A. Inhibition of the human thioredoxin system. A molecular mechanism of mercury toxicity. J Biol Chem. May 2 2008;283(18):11913-23. [Medline].

  7. Basu N, Scheuhammer AM, Rouvinen-Watt K, Evans RD, Grochowina N, Chan LH. The effects of mercury on muscarinic cholinergic receptor subtypes (M1 and M2) in captive mink. Neurotoxicology. Mar 2008;29(2):328-34. [Medline].

  8. Huang CF, Hsu CJ, Liu SH, Lin-Shiau SY. Neurotoxicological mechanism of methylmercury induced by low-dose and long-term exposure in mice: oxidative stress and down-regulated Na+/K(+)-ATPase involved. Toxicol Lett. Feb 15 2008;176(3):188-97. [Medline].

  9. Ceccatelli S, Daré E, Moors M. Methylmercury-induced neurotoxicity and apoptosis. Chem Biol Interact. Nov 5 2010;188(2):301-8. [Medline].

  10. Yamashita T, Ando Y, Sakashita N, et al. Role of nitric oxide in the cerebellar degeneration during methylmercury intoxication. Biochim Biophys Acta. Mar 15 1997;1334(2-3):303-11. [Medline].

  11. Ralston NV, Raymond LJ. Dietary selenium's protective effects against methylmercury toxicity. Toxicology. Nov 28 2010;278(1):112-23. [Medline].

  12. Echeverria D, Woods JS, Heyer NJ, Rohlman D, Farin FM, Li T, et al. The association between a genetic polymorphism of coproporphyrinogen oxidase, dental mercury exposure and neurobehavioral response in humans. Neurotoxicol Teratol. Jan-Feb 2006;28(1):39-48. [Medline].

  13. Echeverria D, Woods JS, Heyer NJ, Martin MD, Rohlman DS, Farin FM, et al. The association between serotonin transporter gene promotor polymorphism (5-HTTLPR) and elemental mercury exposure on mood and behavior in humans. J Toxicol Environ Health A. 2010;73(15):1003-20. [Medline]. [Full Text].

  14. Bose-O'Reilly S, McCarty KM, Steckling N, Lettmeier B. Mercury exposure and children's health. Curr Probl Pediatr Adolesc Health Care. Sep 2010;40(8):186-215. [Medline]. [Full Text].

  15. Dufault R, LeBlanc B, Schnoll R, et al. Mercury from chlor-alkali plants: measured concentrations in food product sugar. Environ Health. Jan 26 2009;8:2. [Medline]. [Full Text].

  16. Washam C. Beastly beauty products: exposure to inorganic mercury in skin-lightening creams. Environ Health Perspect. Feb 2011;119(2):A80. [Medline]. [Full Text].

  17. Tang HL, Chu KH, Mak YF, Lee W, Cheuk A, Yim KF. Minimal change disease following exposure to mercury-containing skin lightening cream. Hong Kong Med J. Aug 2006;12(4):316-8. [Medline].

  18. Espinoza EO, Mann MJ, Bleasdell B. Arsenic and mercury in traditional Chinese herbal balls. N Engl J Med. Sep 21 1995;333(12):803-4. [Medline].

  19. Sallon S, Namdul T, Dolma S, et al. Mercury in traditional Tibetan medicine - panacea or problem?. Hum Exp Toxicol. Jul 2006;25(7):405-12. [Medline].

  20. Garetano G, Stern AH, Robson M, Gochfeld M. Mercury vapor in residential building common areas in communities where mercury is used for cultural purposes versus a reference community. Sci Total Environ. Jul 1 2008;397(1-3):131-9. [Medline].

  21. Saper RB, Kales SN, Paquin J, et al. Heavy metal content of ayurvedic herbal medicine products. JAMA. Dec 15 2004;292(23):2868-73. [Medline].

  22. Kingman A, Albers JW, Arezzo JC, Garabrant DH, Michalek JE. Amalgam exposure and neurological function. Neurotoxicology. Mar 2005;26(2):241-55. [Medline].

  23. Public Health Service. Dental amalgam: a scientific review and recommended Public Health Service strategy for research, education, and regulation. Public Health Service. January 1993;[Full Text].

  24. [Best Evidence] Bellinger DC, Trachtenberg F, Barregard L, et al. Neuropsychological and renal effects of dental amalgam in children: a randomized clinical trial. JAMA. Apr 19 2006;295(15):1775-83. [Medline].

  25. [Best Evidence] DeRouen TA, Martin MD, Leroux BG, et al. Neurobehavioral effects of dental amalgam in children: a randomized clinical trial. JAMA. Apr 19 2006;295(15):1784-92. [Medline].

  26. FDA Issues Final Regulation on Dental Amalgam. July 28, 2009. FDA News Release. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm173992.htm.

  27. Triunfante P, Soares ME, Santos A, Tavares S, Carmo H, Bastos Mde L. Mercury fatal intoxication: two case reports. Forensic Sci Int. Jan 30 2009;184(1-3):e1-6. [Medline].

  28. Deschamps F, Strady C, Deslee G, Menciere-Faroy B, Deschamps S. Five years of follow-up after elemental mercury self-poisoning. Am J Forensic Med Pathol. Jun 2002;23(2):170-2. [Medline].

  29. Bigham M, Copes R. Thiomersal in vaccines: balancing the risk of adverse effects with the risk of vaccine-preventable disease. Drug Saf. 2005;28(2):89-101. [Medline].

  30. Kirby D. Evidence of Harm. Mercury in Vaccine and the Autism Epidemic: A Medical Controversy. New York: Saint Martin's Press; 2005.

  31. Heron J, Golding J. Thimerosal exposure in infants and developmental disorders: a prospective cohort study in the United kingdom does not support a causal association. Pediatrics. Sep 2004;114(3):577-83. [Medline].

  32. Bronstein AC, Spyker DA, Cantilena LR Jr, Green JL, Rumack BH, Heard SE. 2007 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 25th Annual Report. Clin Toxicol (Phila). Dec 2008;46(10):927-1057. [Medline].

  33. Amin-zaki L, Majeed MA, Clarkson TW, Greenwood MR. Methylmercury poisoning in Iraqi children: clinical observations over two years. Br Med J. Mar 11 1978;1(6113):613-6. [Medline]. [Full Text].

  34. Feng X, Li P, Qiu G, et al. Human exposure to methylmercury through rice intake in mercury mining areas, Guizhou province, China. Environ Sci Technol. Jan 1 2008;42(1):326-32. [Medline].

  35. Barregard L. Exposure to inorganic mercury: from dental amalgam to artisanal gold mining. Environ Res. May 2008;107(1):4-5. [Medline].

  36. Myers GJ, Davidson PW. Prenatal methylmercury exposure and children: neurologic, developmental, and behavioral research. Environ Health Perspect. Jun 1998;106 Suppl 3:841-7. [Medline].

  37. Stern AH, Jacobson JL, Ryan L, Burke TA. Do recent data from the Seychelles Islands alter the conclusions of the NRC Report on the toxicological effects of methylmercury?. Environ Health. Jan 30 2004;3(1):2. [Medline].

  38. Davis LE, Kornfeld M, Mooney HS, et al. Methylmercury poisoning: long-term clinical, radiological, toxicological, and pathological studies of an affected family. Ann Neurol. Jun 1994;35(6):680-8. [Medline].

  39. Nierenberg DW, Nordgren RE, Chang MB, et al. Delayed cerebellar disease and death after accidental exposure to dimethylmercury. N Engl J Med. Jun 4 1998;338(23):1672-6. [Medline].

  40. Albers JW, Kallenbach LR, Fine LJ, et al. Neurological abnormalities associated with remote occupational elemental mercury exposure. Ann Neurol. Nov 1988;24(5):651-9. [Medline].

  41. Letz R, Gerr F, Cragle D, Green RC, Watkins J, Fidler AT. Residual neurologic deficits 30 years after occupational exposure to elemental mercury. Neurotoxicology. Aug 2000;21(4):459-74. [Medline].

  42. ATSDR. Agency for Toxic Substances and Disease Registry. Toxicological Profile for Mercury. ATSDR. August 1997.

  43. EPA. Water quality criterion for the protection of human health: methylmercury. Environmental Protection Agency. Jan 2001;EPA-823-R-01-001.

  44. CDC. From the Centers for Disease Control and Prevention. Blood and hair mercury levels in young children and women of childbearing age--United States, 1999. JAMA. Mar 21 2001;285(11):1436-7. [Medline].

  45. Myers GJ, Davidson PW, Cox C, et al. Prenatal methylmercury exposure from ocean fish consumption in the Seychelles child development study. Lancet. May 17 2003;361(9370):1686-92. [Medline].

  46. Canadian Food Inspection Agency. Food safety facts on mercury and fish consumption. Canadian Food Inspection Agency.

  47. Health Canada. Advisory: Information on mercury levels in fish. May 29, 2002. Health Canada Online.

  48. Ontario Ministry of the Environment. Guide to eating Ontario sport fish, 2001-2002. 21st ed rev. Ontario Ministry of the Environment. 2001.

  49. Centers for Disease Control and Prevention. Mercury and Vaccines (Thimerosal). Updated June 2007. Available at http://www.cdc.gov/od/science/iso/concerns/thimerosal.htm.

  50. Madsen KM, Lauritsen MB, Pedersen CB, et al. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. Sep 2003;112(3 Pt 1):604-6. [Medline]. [Full Text].

  51. World Health Organization. World Health Organization: Global Advisory Committee on Vaccine Safety. Rec 32. WHO. Jun 11-12 2003;282-284.

  52. Lawsuit: Bumble Bee Tuna Gave Man Mercury Poisoning. www.foxnews.com. Available at http://www.foxnews.com/health/2010/10/19/lawsuit-bumblebee-tuna-gave-man-mercury-poisoning/. Accessed August 7, 2011.

  53. Environmental Protection Agency (EPA). Spills, Disposal and Site Cleanup. US Environmental Protection Agency. Available at http://www.epa.gov/mercury/spills/index.htm. Accessed March 30, 2009.

  54. Jao-Tan C, Pope E. Cutaneous poisoning syndromes in children: a review. Curr Opin Pediatr. Aug 2006;18(4):410-6. [Medline].

  55. Takaoka S, Kawakami Y, Fujino T, Oh-ishi F, Motokura F, Kumagai Y. Somatosensory disturbance by methylmercury exposure. Environ Res. May 2008;107(1):6-19. [Medline].

  56. Malkani R, Weinstein JM, Kumar N, Victor TA, Bernstein L. Ataxia and cranial neuropathies from subcutaneously injected elemental mercury. Clin Toxicol (Phila). Apr 2011;49(4):334-6. [Medline].

  57. Haut MW, Morrow LA, Pool D, Callahan TS, Haut JS, Franzen MD. Neurobehavioral effects of acute exposure to inorganic mercury vapor. Appl Neuropsychol. 1999;6(4):193-200. [Medline].

  58. Yokoo EM, Valente JG, Grattan L, Schmidt SL, Platt I, Silbergeld EK. Low level methylmercury exposure affects neuropsychological function in adults. Environ Health. Jun 4 2003;2(1):8. [Medline].

  59. Weil M, Bressler J, Parsons P, Bolla K, Glass T, Schwartz B. Blood mercury levels and neurobehavioral function. JAMA. Apr 20 2005;293(15):1875-82. [Medline].

  60. Chang JW, Pai MC, Chen HL, Guo HR, Su HJ, Lee CC. Cognitive function and blood methylmercury in adults living near a deserted chloralkali factory. Environ Res. Nov 2008;108(3):334-9. [Medline].

  61. Boyd AS, Seger D, Vannucci S, Langley M, Abraham JL, King LE Jr. Mercury exposure and cutaneous disease. J Am Acad Dermatol. Jul 2000;43(1 Pt 1):81-90. [Medline].

  62. Dantzig PI. A new cutaneous sign of mercury poisoning?. J Am Acad Dermatol. Dec 2003;49(6):1109-11. [Medline].

  63. Chu CC, Huang CC, Ryu SJ, Wu TN. Chronic inorganic mercury induced peripheral neuropathy. Acta Neurol Scand. Dec 1998;98(6):461-5. [Medline].

  64. Miyakawa T, Murayama E, Sumiyoshi S, Deshimaru M, Fujimoto T. Late changes in human sural nerves in Minamata disease and in nerves of rats with experimental organic mercury poisoning. Acta Neuropathol. Jun 15 1976;35(2):131-8. [Medline].

  65. Risher JF, Amler SN. Mercury exposure: evaluation and intervention the inappropriate use of chelating agents in the diagnosis and treatment of putative mercury poisoning. Neurotoxicology. Aug 2005;26(4):691-9. [Medline].

  66. Li YF, Chen C, Li B, et al. Scalp hair as a biomarker in environmental and occupational mercury exposed populations: suitable or not?. Environ Res. May 2008;107(1):39-44. [Medline].

  67. Urban P, Lukas E, Benicky L, Moscovicova E. Neurological and electrophysiological examination on workers exposed to mercury vapors. Neurotoxicology. Spring 1996;17(1):191-6. [Medline].

  68. Ruedy J. Methylmercury poisoning. CMAJ. Oct 30 2001;165(9):1193-4. [Medline]. [Full Text].

  69. Halbach S, Welzl G. Levels of organic and inorganic mercury in human blood predicted from measurements of total mercury. J Appl Toxicol. Oct 2010;30(7):674-9. [Medline].

  70. Young-Jin S. Mercury. In: Flomenbaum NE, Goldfrank LR, Hoffman RS, Howland MA, et al, eds. Goldfrank's Toxicologic Emergencies. 8th ed. New York: The McGraw-Hill Companies; 2006:96.

  71. [Guideline] Charlton N, Wallace KL. American College of Medical Toxicology - Position Statement: Post-Chelator Challenge Urinary Metal Testing. July 27, 2009;[Full Text].

  72. Guallar E, Sanz-Gallardo MI, van't Veer P, et al. Mercury, fish oils, and the risk of myocardial infarction. N Engl J Med. Nov 28 2002;347(22):1747-54. [Medline].

  73. Rees JR, Sturup S, Chen C, Folt C, Karagas MR. Toenail mercury and dietary fish consumption. J Expo Sci Environ Epidemiol. Jan 2007;17(1):25-30. [Medline].

  74. Sallsten G, Barregard L, Wikkelso C, Schutz A. Mercury and proteins in cerebrospinal fluid in subjects exposed to mercury vapor. Environ Res. May 1994;65(2):195-206. [Medline].

  75. Korogi Y, Takahashi M, Hirai T, et al. Representation of the visual field in the striate cortex: comparison of MR findings with visual field deficits in organic mercury poisoning (Minamata disease). AJNR Am J Neuroradiol. Jun-Jul 1997;18(6):1127-30. [Medline].

  76. White RF, Feldman RG, Moss MB, Proctor SP. Magnetic resonance imaging (MRI), neurobehavioral testing, and toxic encephalopathy: two cases. Environ Res. Apr 1993;61(1):117-23. [Medline].

  77. O'Carroll RE, Masterton G, Dougall N, Ebmeier KP, Goodwin GM. The neuropsychiatric sequelae of mercury poisoning. The Mad Hatter's disease revisited. Br J Psychiatry. Jul 1995;167(1):95-8. [Medline].

  78. Murata K, Weihe P, Budtz-Jorgensen E, Jorgensen PJ, Grandjean P. Delayed brainstem auditory evoked potential latencies in 14-year-old children exposed to methylmercury. J Pediatr. Feb 2004;144(2):177-83. [Medline].

  79. Cantor MO. Mercury lost in the gastrointestinal tract; report of an unusual case. J Am Med Assoc. Jun 9 1951;146(6):560-1. [Medline].

  80. Ragothaman M, Kulkarni G, Ashraf VV, Pal PK, Chickabasavaiah Y, Shankar SK. Elemental mercury poisoning probably causes cortical myoclonus. Mov Disord. Oct 15 2007;22(13):1964-8. [Medline].

  81. Rustam H, Von Burg R, Amin-Zaki L, El Hassani S. Evidence for a neuromuscular disorder in methylmercury poisoning. Arch Environ Health. Apr 1975;30(4):190-5. [Medline].

  82. Forman J, Moline J, Cernichiari E, et al. A cluster of pediatric metallic mercury exposure cases treated with meso-2,3-dimercaptosuccinic acid (DMSA). Environ Health Perspect. Jun 2000;108(6):575-7. [Medline].

  83. Alhamad T, Rooney J, Nwosu A, Maccombs J, Kim YS, Shukla V. Lessons learned from a fatal case of mercury intoxication. Int Urol Nephrol. Jan 14 2011;[Medline].

  84. Grandjean P, Guldager B, Larsen IB, Jorgensen PJ, Holmstrup P. Placebo response in environmental disease. Chelation therapy of patients with symptoms attributed to amalgam fillings. J Occup Environ Med. Aug 1997;39(8):707-14. [Medline].

  85. Zajac A. Mercury in dental fillings. www.losangelestimes.com. Available at http://articles.latimes.com/2010/dec/20/nation/la-na-mercury-dental-qa-20101220. Accessed August 7, 2011.

 
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This is a 1-view, abdominal, upright radiograph in a male patient who intentionally ingested 8 ounces of elemental mercury. Notice how the mercury outlines the large intestine from ascending to descending. Image courtesy of Fred P. Harchelroad, MD, and Ferdinando L. Mirarchi, DO.
Patient with intentional ingestion of mercury from blood pressure instrument. Note how mercury beads can be seen deposited in lung fields. Image courtesy of Shuchi Vyas, MD.
 
 
 
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