Abstract
We report a rare case of fatal intoxication in a 40-year-old man caused by injection of a fluid containing organic mercury, allegedly in an attack with a syringe fixed to the tip of an umbrella. The man suffered from severe neurological symptoms and progressive multiorgan failure and died 10 months later in refractory status epilepticus. Autopsy revealed severe brain atrophy and non-specific kidney damage. Neuropathological examination showed neuronal loss especially in the occipital lobe, distinct granule cell necrosis in the cerebellum and Wallerian degeneration in the brainstem. Postmortem toxicological analysis revealed extremely increased levels of mercury in liver and kidney tissue as well as methylmercury levels in peripheral blood.
Highlights
In the field of legal medicine, intoxications are challenging cases which often occur without typical symptoms and autopsy findings
While large acute exposure causes severe acute inflammatory reactions, chronic low dose ingestion leads to mostly non-specific symptoms [10], and organic mercury compounds like methylmercury lead to damage of the central nervous system
The changes were most prominent in the occipital cortex
Summary
In the field of legal medicine, intoxications are challenging cases which often occur without typical symptoms and autopsy findings. While large acute exposure causes severe acute inflammatory reactions, chronic low dose ingestion leads to mostly non-specific symptoms [10], and organic mercury compounds like methylmercury lead to damage of the central nervous system. In severe cases methylmercury intoxications can lead to tetraplegia, coma or death These symptoms correlate with damage of certain regions of the brain; the occipital lobe, cerebellum and brainstem [11]. After several days to weeks the man showed increasingly reduced general health with fatigue and was hospitalized with severe neurological dysfunctions in somnolent status As his parameters of inflammation were normal, his diastolic blood pressure was high, and his antibody profile and complement activities were normal, sepsis as well as a parainfectious syndrome were considered unlikely. EDTA Blood (initial measurement) EDTA Blood (DMPS treatment) Venous blood (autopsy) Liver (autopsy) Kidney (autopsy)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
