A fatal case of lead poisoning due to a retained bullet

Lead poisoning from a retained bullet or missile is rare and is usually dependent on the location of the missile in a bone or immediately adjacent to a joint. A review of the literature revealed only 14 cases in which there was adequate laboratory documentation of plumbism caused by a retained bullet or missile. Only one of these previously reported cases resulted in death. We report a second death due to lead poisoning from a retained bullet with elevated blood lead levels documented by toxicologic analysis.