Metal mercury poisoning in two boys initially treated for brucellosis in Mashhad, Iran

Elemental mercury (Hg) is the only metal which evaporates in room temperature and its inhalation may cause toxicity. Hg poisoning may occur by mishandling the metal, particularly in children who play with it. Wide-spectrum of the clinical presentations of chronic Hg poisoning may cause misdiagnosis, particularly when history of exposure is unknown. We report two cases of accidental Hg poisoning, which initially had been diagnosed and treated for brucellosis. The patients were two brothers (7 and 14 years old) who presented with pain in their lower extremities, sweating, salivation, weight loss, anorexia and mood changes on admission. Meticulous history taking revealed that they had played with a ball of Hg since 3 months before admission. The level of urinary Hg was 125.9 and 54.2 9 g/L in the younger and older brother, respectively (normal ≤25 g/L). The patients were successfully treated by dimercaprol and discharged in good condition 24 days after admission. These cases are being reported to emphasize the importance of acrodynia as a differential diagnosis for brucellosis in endemic areas.