Karatapanis Stylianos, Lamprianou Fotini, Ntetskas George, Kotis Alexandros
1st Department of Internal Medicine, General Hospital of Rhodes, Rhodes, Greece.
CT and MRI Department, General Hospital of Rhodes, Rhodes, Greece.
BMJ Case Rep. 2015 Oct 5;2015:bcr2014207075. doi: 10.1136/bcr-2014-207075.
A 22-year-old woman was admitted to the emergency department with symptoms of chest discomfort after a suicide attempt by injecting intravenously the amount of mercury extracted from 3 thermometers mixed with alcohol. At presentation, the patient was well oriented with normal vital signs, but a few hours later she presented an abrupt deterioration of her mental status, with confusion, disorientation, tremor and finally stupor. She was transferred to the intensive care unit for monitoring and therapy. A nasogastric tube was immediately placed and the patient received treatment with a chelating agent dimercaptosuccinic acid (DMSA)/succimer 800 mg orally three times a day, a dosage decided on the basis of her body weight, plus phenytoin 125 mg intravenously three times a day. Two hours after treatment initiation, the patient reported a remarkable improvement of her symptoms. However, she experienced seizures during a 6-month period after her discharge.
一名22岁女性因静脉注射从3支与酒精混合的温度计中提取的汞而自杀未遂,随后出现胸部不适症状,被送往急诊科。就诊时,患者神志清楚,生命体征正常,但数小时后,她的精神状态突然恶化,出现意识模糊、定向障碍、震颤,最终陷入昏迷。她被转入重症监护病房进行监测和治疗。立即插入鼻胃管,患者接受螯合剂二巯基丁二酸(DMSA)/二巯基丁二酸胶囊治疗,每天口服3次,每次800毫克,剂量根据她的体重确定,外加苯妥英钠125毫克,每天静脉注射3次。治疗开始两小时后,患者报告症状明显改善。然而,出院后6个月内她出现了癫痫发作。