Acute lead intoxication from a bullet in an intervertebral disc space. A case report

Lead intoxication is an unusual but well documented sequela to a gunshot wound. The risk of plumbism following such an injury depends on several variables, including the mass and surface area of the bullet, its location, the length of time that the lead is in contact with body fluids, the presence of an appropriate solvent, and the effective transport of the solubilized lead to the area of clinical impact. A rich vascular supply to the site where the bullet is lodged and prolonged bathing of the lead fragment with synovial or bursal fluid have been the prerequisites for eliciting plumbism in nearly all reported cases. A review of the literature revealed no previously reported case of plumbism in which the bullet was lodged within an intervertebral disc space.