ACUTE ELEMENTAL MERCURY POISONING IN PEDIATRICS: CLINICAL CASE IN A MINING AREA OF PERU

Abstract

Accidental exposure to elemental mercury is rare, but its health risks in children can be serious, especially in informal mining areas. Systemic toxicity from mercury exposure can occur, and the clinical manifestations of poisoning vary depending on the route of exposure. Elemental mercury ingestion in the pediatric population is uncommon, and its management remains complex due to the lack of established treatment guidelines. We present the pediatric case of a 2-year-old boy from the Chala district of Arequipa, who ingested 30 grams of elemental mercury. The patient presented with mild gastrointestinal symptoms, such as semi- liquid diarrhea and mild abdominal distension. Laboratory tests showed a markedly elevated blood mercury level of 95.49 ng/mL, and imaging revealed radiopaque material in the gastrointestinal tract. The clinical course was favorable, without complications, after receiving supportive care, lactulose, and oral D-penicillamine. Case justification: This case is reported due to the rarity of elemental mercury ingestion in the pediatric population and the favorable outcome without systemic complications despite thehigh ingested load. It also highlights the importance of recognizing the risk in rural mining communities exposed to mercury from informal extraction activities, where therapeutic resources are limited. Early and conservative management of this patient led to an uncomplicated outcome, underscoring the need for individualized protocols, rigorous monitoring, and community prevention strategies to reduce the risk of accidental exposure in children in mining areas.