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Unusual complication of an Alaskan cruise: thinking outside the box
  1. Deepti Bhandare1 and
  2. Rupam Ruchi2
  1. 1 Department of Cardiolgy, Florida Hospital Heartland Medical Center, Sebring, Florida, USA
  2. 2 Department of Medicine/Nephrology, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Rupam Ruchi, Rupam.Ruchi{at}


A 69-year-old man with a medical history of hypertension and diabetes presented with altered mental status once he returned from a 14-day Alaskan cruise. An extensive workup for stroke was negative. His physical examination was normal without any focal motor deficits, but he had developed memory loss and paresthesia. He admitted to eating a lot of fish when he was in Alaska. The whole-blood mercury level was found to be elevated. He was managed conservatively and his symptoms resolved completely in a few days. This led to a diagnosis of organic mercury toxicity.

  • neurology (drugs and medicines)
  • poisoning

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  • Contributors DB is the attending physician who follows the patient in her office. She reviewed patient’s history as well as his chart and did part of the write up. RR finished the write up and reviewed and revised the full manuscript for critically important intellectual content. She approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.