Mercury in the Needle: A Case of Malicious Injection and Toxicity

Intentional or accidental injection of mercury into soft tissue is rare. Mercury toxicity typically arises from ingestion or inhalation with instances of subcutaneous injection documented in a limited number of case studies. Most reported cases involve either accidental exposure or deliberate acts, often presenting as painful granulomas, with systemic symptoms a rarity. We present a compelling case involving a 39-year-old woman who developed a localized, painful gluteal lesion filled with mercury following multiple injections of what were purported to be multivitamin ampoules, administered by her ex-husband, a healthcare professional. Remarkably, the patient exhibited a serum mercury level of 345 μg/L without significant systemic manifestations which decreased after a course of treatment with succimer. This report highlights one of the rarest, if not the only documented instance of mercury toxicity caused by subcutaneous injection, potentially with homicidal intent.