The Dead Sea has a very high concentration of bromide (5 g/L), which is also present in the salt prepared from its waters.
Bromide toxicity can occur:
(1) if the person ingests a lot of the salt
(2) if the person has renal insufficiency
(3) if the person is also taking bromide from other sources
The patient may present with:
(1) an acneiform skin eruption, plaques, bullae or ulcers
(2) emotional or psychiatric deterioration including hallucinations and agitations
(3) neurologic complaints including slurred speech, confusion, seizures and coma
(4) unexplained fever
(5) a very high serum chloride (due to reaction of bromide with the chloride electrode in chemical analyzers) and a very negative anion gap
