Permeated

A 15-year-old boy presents with a high fever, an intermittent non-productive cough, and dyspnea for one day, along with a generalized itchy rash for two days.

On close questioning, he reveals that he has been performing chemistry experiments for the last several days, on a sample of mercury he obtained from a broken thermometer.

He lives with his parents and younger brother, all of whom are currently in good health. His medical history is unremarkable with no history of allergies.

Select Relevant Investigations
Complete blood count

Performed

WBC: 4,900/mm3 (4,500-12,000)
Hb: 13.1 g/dL (13-16)
Plt: 198,000/mm3 (150,000-400,000)
Renal function tests

Performed

Blood urea: 75 mg/dL (10-50)
Serum creatinine: 1.6 mg/dL (0.4-1.5)
Serum mercury levels

Performed

Serum mercury: 79 μg/L (0.6-10)
Chest X-Ray

Performed

The chest X-ray shows bilateral non-homogenous basal opacities, with a few nonspecific nodular lesions.

Select Relevant Management
Antihistamines
Bronchodilators
ICU care
DMPS chelation