Typical agent: mercuric chloride
CNS distribution: Inorganic mercury poorly penetrates the blood-brain barrier, so neurologic findings are not prominent.
A low dose exposure may be asymptomatic. A high dose exposure can be fatal in a few hours, usually from gastrointestinal or renal toxicity.
Gastrointestinal findings:
(1) pharyngitis, stomatitus and gingivitis, with burning mouth
(2) excessive salivation
(3) metallic taste
(4) nausea
(5) vomiting, which may be bloody
(6) abdominal pain
(7) abdominal tenderness on palpation
(8) esophagitis and/or gastritis, which may be severe
(9) colitis, which may be severe
(10) GI bleeding, ranging guaiac positive stool to massive bleeding
Renal findings:
(1) oliguria or anuria
Skin findings:
(1) urticaria
(2) vesication (blistering)
(3) acrodynia in a young child
Systemic findings in severe ingestions may include:
(1) anemia with pallor and fatigue
(2) vascular collapse with shock
Laboratory findings:
(1) elevated urinary mercury
(2) elevated blood mercury concentration early after intoxication
(3) proteinuria
(4) elevated creatinine
(5) anemia
