Acute Hypoxemic Respiratory Failure due to Mercury Inhalation in a Two-Year Old Female

Introduction: Mercury is a toxic trace metal that causes acute respiratory failure when vaporized and inhaled. We report the presentation and management of a two-year-old female with hypoxemic respiratory failure secondary to elemental mercury inhalation. Case report: A 2-year-old female presented to our facility with acute respiratory distress. She developed hypoxemic respiratory failure requiring venoarterial extracorporeal membrane oxygenation. She was found to have high serum mercury levels and was managed with dimercapto succinic acid chelation therapy and high-dose corticosteroids. The patient survived and subsequently recovered. Discussion: This is the first pediatric case of fulminant pneumonitis caused by elemental mercury inhalation managed with venoarterial extracorporeal membrane oxygenation reported in the medical literature.