Auto-aggressive metallic mercury injection around the knee joint: a case report
Identifieur interne : 000561 ( Main/Exploration ); précédent : 000560; suivant : 000562Auto-aggressive metallic mercury injection around the knee joint: a case report
Auteurs : Joerg Friesenbichler [Autriche] ; Werner Maurer-Ertl [Autriche] ; Patrick Sadoghi [Autriche] ; Elisabeth Wolf [Autriche] ; Andreas Leithner [Autriche]Source :
- BMC Surgery ; 2011.
Abstract
Accidental or intentional subcutaneous and/or intramuscular injection of metallic mercury is an uncommon form of poisoning. Although it does not carry the same risk as mercury vapour inhalation, it may cause destructive early and late reactions.
Herein we present the case of a 29-year-old male patient who developed an obsessive-compulsive disorder causing auto-aggressive behaviour with injection of elemental mercury and several other foreign bodies into the soft tissues around the left knee about 15 years before initial presentation. For clinical examination X-rays and a CT-scan of the affected area were performed. Furthermore, blood was taken to determine the mercury concentration in the blood, which showed a concentration 17-fold higher than recommended. As a consequence, the mercury depots and several foreign bodies were resected marginally.
Blood levels of mercury will decrease rapidly following surgery, especially in combination with chelating therapy. In case of subcutaneous and intramuscular injection of metallic mercury we recommend marginal or wide excision of all contaminated tissue to prevent migration of mercury and chronic inflammation. Nevertheless, prolonged clinical and biochemical monitoring should be performed for several years to screen for chronic intoxication.
Url:
DOI: 10.1186/1471-2482-11-31
PubMed: 22093686
PubMed Central: 3226429
Affiliations:
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Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Sadoghi, Patrick" sort="Sadoghi, Patrick" uniqKey="Sadoghi P" first="Patrick" last="Sadoghi">Patrick Sadoghi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Wolf, Elisabeth" sort="Wolf, Elisabeth" uniqKey="Wolf E" first="Elisabeth" last="Wolf">Elisabeth Wolf</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, 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wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Maurer Ertl, Werner" sort="Maurer Ertl, Werner" uniqKey="Maurer Ertl W" first="Werner" last="Maurer-Ertl">Werner Maurer-Ertl</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Sadoghi, Patrick" sort="Sadoghi, Patrick" uniqKey="Sadoghi P" first="Patrick" last="Sadoghi">Patrick Sadoghi</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Wolf, Elisabeth" sort="Wolf, Elisabeth" uniqKey="Wolf E" first="Elisabeth" last="Wolf">Elisabeth Wolf</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author><author><name sortKey="Leithner, Andreas" sort="Leithner, Andreas" uniqKey="Leithner A" first="Andreas" last="Leithner">Andreas Leithner</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz</wicri:regionArea><wicri:noRegion>8036 Graz</wicri:noRegion></affiliation></author></analytic><series><title level="j">BMC Surgery</title><idno type="e-ISSN">1471-2482</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Accidental or intentional subcutaneous and/or intramuscular injection of metallic mercury is an uncommon form of poisoning. Although it does not carry the same risk as mercury vapour inhalation, it may cause destructive early and late reactions.</p></sec><sec><title>Case Presentation</title><p>Herein we present the case of a 29-year-old male patient who developed an obsessive-compulsive disorder causing auto-aggressive behaviour with injection of elemental mercury and several other foreign bodies into the soft tissues around the left knee about 15 years before initial presentation. For clinical examination X-rays and a CT-scan of the affected area were performed. Furthermore, blood was taken to determine the mercury concentration in the blood, which showed a concentration 17-fold higher than recommended. As a consequence, the mercury depots and several foreign bodies were resected marginally.</p></sec><sec><title>Conclusion</title><p>Blood levels of mercury will decrease rapidly following surgery, especially in combination with chelating therapy. In case of subcutaneous and intramuscular injection of metallic mercury we recommend marginal or wide excision of all contaminated tissue to prevent migration of mercury and chronic inflammation. Nevertheless, prolonged clinical and biochemical monitoring should be performed for several years to screen for chronic intoxication.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Franzen, C" uniqKey="Franzen C">C Franzen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Heise, La" uniqKey="Heise L">LA Heise</name></author><author><name sortKey="Wagener, Bm" uniqKey="Wagener B">BM Wagener</name></author><author><name sortKey="Vigil, Jr" uniqKey="Vigil J">JR Vigil</name></author><author><name sortKey="Othman, M" uniqKey="Othman M">M Othman</name></author><author><name sortKey="Shahinpoor, P" uniqKey="Shahinpoor P">P Shahinpoor</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lech, T" uniqKey="Lech T">T Lech</name></author><author><name sortKey="Goszcz, H" uniqKey="Goszcz H">H Goszcz</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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sortKey="Leithner, Andreas" sort="Leithner, Andreas" uniqKey="Leithner A" first="Andreas" last="Leithner">Andreas Leithner</name><name sortKey="Maurer Ertl, Werner" sort="Maurer Ertl, Werner" uniqKey="Maurer Ertl W" first="Werner" last="Maurer-Ertl">Werner Maurer-Ertl</name><name sortKey="Sadoghi, Patrick" sort="Sadoghi, Patrick" uniqKey="Sadoghi P" first="Patrick" last="Sadoghi">Patrick Sadoghi</name><name sortKey="Wolf, Elisabeth" sort="Wolf, Elisabeth" uniqKey="Wolf E" first="Elisabeth" last="Wolf">Elisabeth Wolf</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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