Reports of toxic effects from a single injection of bismuth, especially when associated with anuria, are rare enough to merit mention. Fatal terminations of such poisonings have been reported by Aubertin and Destouches,1 by Dowds2 (3 cases), by Keith and Osterberg3 and by Eitzen.4 Beerman, in a review of the literature in 1932,5 found reports on 22 cases of fatalities due to the use of bismuth in the treatment of syphilis. Most of the reports have been on adult patients under treatment for syphilis or on patients who had had repeated doses of the metal.
Bismuth is somewhat similar to mercury in its action on body tissue. The toxic effects usually noted are stomatitis, gastritis and renal damage. The effect on the kidney may be stimulating, and diuretic oliguria is often produced.
Anuria as a result of a single dose of bismuth, especially in infants,
MCCLENDON SJ. TOXIC EFFECTS WITH ANURIA FROM A SINGLE INJECTION OF A BISMUTH PREPARATION: REPORT OF TWO CASES. Am J Dis Child. 1941;61(2):339–341. doi:10.1001/archpedi.1941.02000080129015
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