A febrile 12 month old child presented after breaking the thermometer and swallowing the mercury during oral measurement of temperature by his mother; being a dentist. The child was febrile with a sore throat ,neithert dyspniec nor altered sensorium on clinical examination. . The thermometer was manufactured by a well known company and the volume of the contained mercury was 0.5ml.The mother was advised not to be anxious and avoid giving charcoal and informed that mercury would be got rid of along with bowel motions.and The infant was sent home and its 6 month of follow up was good with no complications . <br />Discussion and Conclusion :<br />Children and elderly are victims to intoxication ,either because of shivering associated with high fever or due to depressed mentality that glass medical thermometers are likely to be damaged and mercury is swallowed so there will be a risk of heavy metal poisoning. <br />Murcury inside medical thermometers is manufactured to be non absorbable by gastrointestinal mucosa ,if it is swallowed. The absorption of elemental mercury from intact skin 1 or the gastrointestinal tract is negligible <br /> <br />But the amount of swallowed mercury determines the state of toxicity. Thermometer bulb contains 0.5- 0.6 ml which will not reach to level of toxicity.<br />Metallic mercury ingested in a single acute dose, as with a mercury thermometer containing about 500–700 mg of elemental mercury is virtually non-toxic, however, significant exposure may occur through the inhalation of mercury vapours.3<br />1 Acute inhalation of mercury vapour leads to the development of acute symptoms such as cough, breathlessness and chest tightness after a few hours of exposure 4 <br />different types of mercury that cause health problems .They are elementary ,organic and non organic. The elementary type is found in glass thermometers, flourescent light bulbs ,electrical switches ,dental fillings and some medical equipment.5<br />Abdominal or chest x rays may be helpful in follow up the patient management by viewing the metal quantity and reduction. Serum and urine level of mercury are important if the ingested amount was significant and associated with neurological symptoms or signs .<br />A lot of damage can occur, if elemental mercury gets into the air in the form of small droplets that are breathed into the lungs. This often occurs by mistake when people try to vacuum up mercury that has spilled onto the ground. Depending on how much mercury is inhaled, permanent lung damage and death may occur. Long-term brain damage from inhaled elemental mercury can also occur.<br /> In conclusion,we should exclude child abuse and trial of suicide among adults then if the volume of the bulb of thermometere was less than 6 ml we can manage him through assurance and avoidance of induction of vomiting and active charcoal ingestion.. if the patient presented with tightness of breath or epilepsy or psychological behaviour admission and investigations; serological, imaging and toxicology will be necessarily required. <br /> References <br /><br />1-Hursh JB, Clarkson TW, Miles EF, Goldsmith LA. Percutaneous absorption of mercury vapor by man. Arch Environ Health. 1989;44:120–127. <br /> 2-. Wright N, Yeoman WB, Carter GF. Massive oral ingestion of elementary mercury without poisoning. Lancet 1980; 1:206.: 3-Ozuah P. Mercury poisoning. Curr Probl Pediatr 2000; 30: 91–9 <br /> 4-Moxham JP, Lee PK. Broken glass mercury thermometer: a difficult airway foreign body. Otolaryngol Head Neck Surg 2002; 127: 339–41 <br /> 5-Mahanjan PV. Heavy metal intoxication . In Kliegman RM.St.Geme JW,Blum NJ,Shah SS,Tasker RC, Wilson KM.eds.Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA:2020 chap 738.<br />Assistant Prof. Dr. Kadhim Ch. Hasan al Hamadani<br /><br />