People who may experience an injection of elemental mercury:
(1) accidental during cardiac catheterization or other medical procedure
(2) accidental in an injection drug user
(3) intentional as an suicide attempt
(4) psychiatric disorder
(5) intentional for perceived health or physical benefit
The sequelae depend on:
(1) the amount injected
(2) the location of the injection
(3) the number of times injections occurred
(4) the size of the individual globules of mercury
If injected into subcutaneous tissue, it results in a granulomatous reaction.
If injected into a vein, then it can result in:
(1) thrombophlebitis
(2) pulmonary embolism, which may be multifocal. This can may result in pulmonary infarction or totally asymptomatic.
(3) peripheral infarction, if the mercury can pass through the lung capillaries into the pulmonary vein and into the arterial blood
If injected into an artery, then it can cause:
(1) arterial thrombosis
(2) distal infarction in the distribution of the artery.
Delayed multisystem toxicity may occur as the mercury is oxidized to mercuric ion.
A large deposit may be surgically excised since it can be a depot for chronic absorption.
Laboratory findings:
(1) Blood mercury levels are elevated if there has been a large intravascular injection.
