Reactions 748 - 24 Apr 1999

Merbromin

Mercury poisoning in a neonate: case reportA newborn girl developed mercury poisoning after 2%

merbromin [‘Mercurochrome’] was topically applied to a largeomphalocoele that had been detected by prenatal ultrasound.

The neonate was delivered at 38.5 weeks gestation bycaesarean section and weighed 3498g. Topical povidone-iodine was applied twice daily over the omphalocoele withdressing changes for the first 4 days of life, and thenmerbromin was applied twice daily from days 5 to 10. Overall,60ml of merbromin was used. Since the hospital had nofurther supplies of merbromin, the girl was then treated withsilver sulfadiazine.

The neonate’s blood mercury concentration was 252 µg/L(normal 0–10) in a sample taken on the ninth day of life. Herurine mercury concentrations were 1105 and 270 µg/L on thetenth and eleventh days of life, respectively. These laboratoryresults were not available until 2 days later, and it was thenrecommended that the neonate be treated with oral succimer.However, this was not administered because of the risk ofabdominal distension. Five days after merbromin wasdiscontinued, the neonate’s blood mercury concentration haddecreased to 1 µg/L. [Patient outcome not stated.]

Author comment: ‘Merbromin is contraindicated in thetreatment of omphalocele owing to its limited therapeuticvalue, its rapid absorption across the peritoneum [and] its highpotential for mercury intoxication.’Mullins ME, et al. Iatrogenic neonatal mercury poisoning from Mercurochrome(Rm) treatment of a large omphalocele. Clinical Pediatrics 38: 111-112, Feb 1999 -USA 800750039

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Reactions 24 Apr 1999 No. 7480114-9954/10/0748-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved