Asia Pacific Journal of Medical Toxicology

ARDS Induced by Mercury Vapors from Amalgam During Dental Procedure: A Case Report

Document Type : Case Report

Authors

Ahmadreza Mashreghi 1
Anahita Alizadeh ghamsari 2
Arman Hakemi 2

1 M.D, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

https://doi.org/10.22038/apjmt.2025.85368.1494
Abstract
Background: Acute respiratory distress syndrome (ARDS) is a rare but severe complication of elemental mercury vapor inhalation. Dental amalgam, a source of mercury, poses an occupational and patient risk if not handled with appropriate precautions. We report a case of severe ARDS secondary to acute mercury vapor toxicity from a dental procedure.
Case Presentation: A 55-year-old male presented to the emergency department with acute respiratory distress that began shortly after a 10-minute exposure to dental amalgam vapors during a procedure. His initial urinary mercury level was markedly elevated at 853.2 µg/L. A chest CT scan confirmed severe ARDS, showing significant bilateral pulmonary involvement. The patient was admitted and immediately started on a treatment regimen including the chelating agent Succimer and broad-spectrum antibiotics to prevent secondary infection.
Results: After a seven-day inpatient course of chelation therapy, the patient showed significant clinical improvement. A follow-up chest CT revealed a marked reduction in the pulmonary lesions. He was discharged in stable condition with instructions to continue oral Succimer therapy for an additional two weeks to ensure complete systemic detoxification.
Conclusion: This case highlights that acute, high-intensity exposure to mercury vapor during dental procedures can lead to life-threatening ARDS. It underscores the critical importance of prompt diagnosis and immediate initiation of chelation therapy with agents like Succimer to mitigate pulmonary injury and prevent irreversible complications. Furthermore, this report emphasizes the necessity of stringent preventive safety measures in dental settings and the value of comprehensive follow-up to monitor for long-term sequelae of mercury toxicity.

Keywords

ARDS
Dental Amalgam
Mercury Vapors
succimer
Subjects
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Asia Pacific Journal of Medical Toxicology
Volume 14, Issue 3
Summer 2025
Pages 124-126

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