Types of mercury involved may include:
(1) elemental mercury
(2) mercurous chloride (calomel) or mercuric chloride
(3) phenylmercuric compound
(4) ammoniated mercury ointment
Clinical features:
(1) pain and swelling in the extremities
(2) pink rash involving the toes, soles of the feet, fingers and palms of the hands, which may be followed by skin peeling
(3) red color to the cheeks and tip of the nose
(4) failure to thrive
(5) anorexia
(6) generalized miliaria-type skin rashes
(7) photophobia
(8) loss of teeth with ulceration of the gums
(9) behavioral changes, with listlessness, shyness, outbursts and irritability
(10) insomnia
(11) excessive catecholamine stimulation (due to inhibition of the enzyme converting catecholamines to metanephrine) with:
(11a) profuse sweating
(11b) tachycardia
(11c) hypertension
Laboratory findings:
(1) elevated epinephrine, norepinephrine, vanillylmandelic acid, and homovanillic acid in the urine
(2) basal urinary excretion of mercury may be normal or elevated
(3) urinary excretion of mercury is increased following therapy with DMSA (dimercapto succininc acid) or NAP (N-acetyl-D,L-penicillamine)
Complications:
(1) dehydration, especially in warm weather
(2) secondary skin infections
