title: Acute mercury poisoning presenting as fever of unknown origin in an adult woman: a case report.
abstract: BACKGROUND
  Mercury intoxication may present in a wide range of clinical forms from a simple disease to fatal poisoning. This article presents a case of acute mercury poisoning, a rare condition that presents challenges for diagnosis with fever of unknown origin.
  
  
  METHODS
  A 52-year-old Caucasian woman was admitted to the hospital with high fever, sore throat, a rash over her entire body, itching, nausea, and extensive muscle pain. She had cervical, bilateral axillary and mediastinal lymphadenopathies. We learned that her son and husband had similar symptoms. After excluding infectious pathologies, autoimmune diseases and malignancy were investigated. Multiple organs of our patient were involved and her fever persisted at the fourth week of admission. A repeat medical history elicited that her son had brought mercury home from school and put it on the hot stove, and the family had been exposed to the fumes for a long period of time. Our patient's serum and urine mercury levels were high. She was diagnosed with mercury poisoning and treated accordingly.
  
  
  CONCLUSIONS
  Mercury vapor is a colourless and odorless substance. Therefore, patients with various unexplained symptoms and clinical conditions should be questioned about possible exposure to mercury.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, Dişkapi Yildirim Beyazit, Training and Research Hospital, Ankara, Turkey. drgonulcicek@hotmail.com.
authors.forename: Gonul
authors.initials: G
authors.lastname: Cicek-Senturk
authors.forename: Fatma Aybala
authors.initials: FA
authors.lastname: Altay
authors.forename: Aysegul
authors.initials: A
authors.lastname: Ulu-Kilic
authors.forename: Yunus
authors.initials: Y
authors.lastname: Gurbuz
authors.forename: Ediz
authors.initials: E
authors.lastname: Tutuncu
authors.forename: Irfan
authors.initials: I
authors.lastname: Sencan
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D015913:Chelation Therapy / Q000379:methods; D017291:Clarithromycin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000627:therapeutic use; D005076:Exanthema / Q000139:chemically induced / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000188:drug therapy; D005335:Fever of Unknown Origin / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D008628:Mercury / Q000097:blood / Q000652:urine; D008630:Mercury Poisoning / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D010396:Penicillamine / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D002443:Ceftriaxone; D008628:Mercury; D010396:Penicillamine; D017291:Clarithromycin; D004318:Doxycycline
references.citation: J Am Acad Dermatol. 2000 Jul;43(1 Pt 1):81-90
references.pmid: 10863229
references.citation: Chest. 1991 Jan;99(1):185-90
references.pmid: 1984951
references.citation: Can Respir J. 2006 Apr;13(3):150-2
references.pmid: 16642230
references.citation: Clin Toxicol (Phila). 2008 Jan;46(1):1-21
references.pmid: 18167033
references.citation: Curr Med Chem. 2008;15(28):3000-10
references.pmid: 19075648
references.citation: Hum Exp Toxicol. 1992 May;11(3):201-10
references.pmid: 1352115
references.citation: J Med Case Rep. 2008 Mar 06;2:72
references.pmid: 18325096
references.citation: Environ Health Perspect. 2002 Feb;110(2):129-32
references.pmid: 11836139
references.citation: BMC Emerg Med. 2010 Mar 19;10:7
references.pmid: 20302609
references.citation: Eur Respir J. 1990 Feb;3(2):202-19
references.pmid: 2178966