High silver concentrations in biological samples following different exposures: Two case reports

Area of Science:

• Toxicology
• Materials Science

Background:

• Silver's widespread use in industry, confectioneries, and medicine highlights its antibiotic properties.
• Limited documentation exists on silver toxicity, particularly outside occupational exposure contexts.

Observation:

• Two cases revealed elevated silver concentrations in biological samples.
• Patient 1 exhibited grey cuticle marks linked to consuming silver-coated sweets.
• Patient 2 developed agranulocytosis and thrombocytopenia after applying a silver sulfadiazine cream to extensive burns.

Findings:

• Inductively coupled plasma-mass spectrometry (ICP-MS) confirmed elevated silver levels in blood, urine, and sweets.
• Significant silver absorption occurred through large burn areas, contrasting with minimal absorption through intact skin.
• Reduced sweet consumption led to normalized plasma silver levels in Patient 1.

Implications:

• Topical silver absorption is significant in large burns, necessitating careful application.
• Hematological parameters improved post-cessation of silver exposure.
• Further research is warranted to assess silver and sulfadiazine levels in burn patients to inform broader population safety guidelines.