Toxic encephalopathy due to mercury: A rare case report and literature review.

Menghong Zou, Junfeng Li, Hongchao Yao, Qionglan Dong, Qiang Zeng, Qibing Tang, Jie Zhang, Hongwei Li, Jisheng Wang

Journal: Medicine 2025;104(37):e44037

PMID: 40958342

Abstract

RATIONALE

Mercury toxic encephalopathy is uncommonly encountered in clinical practice.

PATIENT CONCERNS

The aim of presenting this case is to increase the awareness of this disease, especially regarding its radiological presentation.

DIAGNOSES

Toxic encephalopathy due to mercury.

INTERVENTIONS

The medical team administered sodium dimercaptopropane sulfonate as a mercury antagonist and treated with plasma purification and massive hydration to promote mercury excretion.

OUTCOMES

Following admission, the patient underwent an magnetic resonance imaging (MRI) examination. The results revealed symmetrical alterations in the brain parenchyma (including both cerebrum and cerebellum), characterized by hypoperfusion on MRI perfusion imaging. The patient died after a series of lifesaving measures.

LESSONS

Mercury poisoning encephalopathy is a rare disorder for which currently established diagnostic criteria are lacking. On brain MRI scans, it manifests as symmetric cerebral edema, involving the parenchyma of both the cerebrum and cerebellum. It is important to question patients carefully about any history of exposure to mercury-containing drugs.

Address: Department of Radiology, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, Sichuan Province, People's Republic of China.; School of Pharmacy, Southwest Medical University, Luzhou, Sichuan Province, People's Republic of China.; Intensive Care Unit, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, Sichuan Province, People's Republic of China.; Department of Respiratory Medicine, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, Sichuan Province, People's Republic of China.; School of Pharmacy, Southwest Medical University, Luzhou, Sichuan Province, People's Republic of China.; Department of Pharmacy, The Third Hospital of Mianyang (Sichuan Mental Health Center), Mianyang, Sichuan Province, People's Republic of China.

DOI: 10.1097/MD.0000000000044037

MeSH Terms: Humans, Magnetic Resonance Imaging, Mercury Poisoning, Nervous System, Fatal Outcome, Male, Mercury, Mercury Poisoning, Brain, Adult