Self-Subcutaneous Injection of Elemental Mercury: A Report of a Rare Case From Pakistan.

Deliberate subcutaneous injection of mercury by a mentally healthy individual is rare. It has been frequently reported in individuals with severe depressive disorders during suicide attempts, as well as among athletes seeking performance enhancement and in certain contexts related to sexual gratification. Here, we present the case of a 28-year-old male patient who deliberately self-injected mercury subcutaneously into his abdomen that led to the formation of a painful induration/abscess in the midline of the abdomen. X-ray of the abdomen showed multiple subcutaneous radio-opaque deposits. A surgical procedure was thereby performed to treat the abscess. However, the patient did not develop the clinical signs of chronic poisoning, suggesting that subcutaneous mercury injection may carry a low risk of systemic toxicity compared with other routes of exposure. The patient denied any psychiatric illness and did not disclose the motive for mercury injection. The patient also has a prior history of hospital admission in a different city for chest wound debridement following mercury injection. The report highlights the timely psychiatric referral and evolution of every patient of subcutaneous mercury injection to avoid repeated hospital presentations and the possibility of systemic toxicity. To our knowledge, this is the first reported case of deliberate subcutaneous elemental mercury injection from Pakistan.