What are umbilical granulomas. How do they form in newborns. What treatments are available for umbilical granulomas. How can silver nitrate help treat umbilical granulomas. What are the potential risks and complications of umbilical granulomas. How can parents prevent umbilical granuloma infections. When should you seek medical attention for an umbilical granuloma.

Understanding Umbilical Granulomas: A Common Newborn Concern

Umbilical granulomas are small, red bumps of tissue that can develop in a newborn’s belly button during the first few weeks after birth. These granulomas are a type of scar tissue that forms as the umbilical cord stump heals and falls off. While they may appear concerning to new parents, umbilical granulomas are relatively common, affecting approximately 1 in 500 babies.

Umbilical granulomas have a distinct appearance:

• Small, red lumps in the navel
• Shiny surface
• Covered in clear discharge

Can adults develop umbilical granulomas? While rare, adults may experience umbilical granulomas, typically as a result of trauma to the belly button area. Navel piercings are a common cause of adult umbilical granulomas, which can be painful unlike those in infants.

The Formation and Causes of Umbilical Granulomas

How do umbilical granulomas form in newborns? After the umbilical cord is cut at birth, a small stump remains on the baby’s abdomen. In most cases, this stump falls off naturally within a few weeks, and the area heals without complications. However, in some instances, the healing process can lead to the formation of an umbilical granuloma.

Factors that may contribute to the development of umbilical granulomas include:

• Delayed healing of the umbilical cord stump
• Excessive moisture in the navel area
• Improper care of the umbilical cord stump
• Individual susceptibility to scar tissue formation

Health Implications of Umbilical Granulomas

Are umbilical granulomas a serious health concern? While generally considered minor complications, umbilical granulomas do require attention and treatment. If left untreated, these granulomas can continue to grow slowly and may become susceptible to infection.

Potential health implications of umbilical granulomas include:

1. Persistent discharge from the navel
2. Discomfort or irritation in the affected area
3. Risk of infection
4. Delayed healing of the umbilical area

Is there a risk of infection with umbilical granulomas? Yes, infected granulomas can pose a critical health problem. Since these growths are connected to the umbilical opening, any infection can spread quickly to surrounding tissues and potentially enter the bloodstream. Prompt medical attention is crucial if signs of infection are present.

Effective Treatments for Umbilical Granulomas

How are umbilical granulomas treated? Several treatment options are available for umbilical granulomas, most of which can be performed in a pediatrician’s office. The choice of treatment depends on the size of the granuloma, the presence of any complications, and the preference of the healthcare provider.

Silver Nitrate: A Primary Treatment Option

Silver nitrate is one of the most common and effective treatments for umbilical granulomas in infants. How does silver nitrate work to treat umbilical granulomas? The silver nitrate is applied directly to the granuloma, where it cauterizes the tissue, effectively burning it off. This process is painless for babies as the granuloma tissue lacks nerve endings.

Benefits of silver nitrate treatment include:

• Quick and effective removal of the granuloma
• Minimal discomfort for the infant
• Can be performed in a doctor’s office
• Often requires only one or two applications

Alternative Treatment Methods

What other treatments are available for umbilical granulomas? In addition to silver nitrate, healthcare providers may use the following methods:

1. Liquid nitrogen: This super-cooled liquid freezes the granuloma, causing it to dissolve over time.
2. Suture thread ties: The granuloma is tied off with a suture thread, cutting off its blood supply and causing it to shrivel and disappear.
3. Salt application: Salt can be applied to dry out the granuloma, leading to its gradual shrinkage.
4. Surgical removal: In rare cases, particularly with infected granulomas, surgical excision may be necessary.

Preventing Umbilical Granuloma Infections

How can parents prevent infections in umbilical granulomas? While it may be challenging to prevent the initial formation of granulomas, steps can be taken to minimize the risk of infection:

• Keep the navel area clean and dry
• Gently clean the belly button with warm water and mild soap
• Avoid using harsh chemicals or alcohol on the affected area
• Ensure proper diaper placement to prevent irritation
• Follow the pediatrician’s instructions for care

Is it important to monitor the umbilical area after treatment? Yes, even after treatment, it’s crucial to keep a close eye on the navel area to ensure proper healing and to watch for any signs of recurrence or infection.

Recognizing When Medical Attention is Necessary

When should parents seek immediate medical care for an umbilical granuloma? While all granulomas should be evaluated by a healthcare provider, certain symptoms warrant urgent medical attention:

• Fever exceeding 100.4°F (38°C)
• Rash or redness around the belly button
• Bleeding from the granuloma
• Foul-smelling discharge from the navel
• Swelling or increased redness in the surrounding area
• Signs of pain when touching the baby’s abdomen

How quickly should parents act if they suspect an infection? If any of these symptoms are present, it’s crucial to seek medical care immediately to prevent the potential spread of infection and ensure prompt treatment.

Long-term Outlook and Care for Umbilical Granulomas

What is the prognosis for babies with treated umbilical granulomas? The outlook for infants with properly treated umbilical granulomas is generally excellent. Most granulomas resolve completely with appropriate treatment, leaving no long-term effects on the child’s health or appearance of the navel.

Key points for long-term care and monitoring include:

1. Follow-up appointments: Attend all scheduled follow-up visits with the pediatrician to ensure proper healing.
2. Ongoing observation: Continue to monitor the navel area for any signs of recurrence or unusual changes.
3. Maintaining hygiene: Emphasize good hygiene practices as the child grows to prevent future navel-related issues.
4. Awareness of family history: Be mindful of any family history of umbilical abnormalities, as some conditions may have a genetic component.

Addressing Parental Concerns and Emotional Support

How can healthcare providers address parental concerns about umbilical granulomas? It’s natural for parents to feel anxious when their newborn develops any type of abnormality. Healthcare providers play a crucial role in alleviating these concerns through education and support.

Strategies for supporting parents include:

• Providing clear, concise information about the condition and its treatment
• Offering reassurance about the generally benign nature of umbilical granulomas
• Demonstrating proper care techniques
• Encouraging parents to ask questions and voice their concerns
• Providing resources for further information and support

Is it helpful for parents to connect with others who have experienced similar issues? Yes, many parents find comfort and valuable insights by connecting with other families who have navigated the challenges of umbilical granulomas. Support groups, online forums, and local parenting networks can be excellent resources for shared experiences and advice.

Advancements in Umbilical Granuloma Research and Treatment

Are there ongoing research efforts focused on umbilical granulomas? While umbilical granulomas are generally well-understood and effectively treated, medical research continues to explore new treatment options and preventive measures.

Current areas of research and development include:

1. Novel topical treatments with reduced side effects
2. Improved diagnostic techniques for distinguishing granulomas from other umbilical abnormalities
3. Investigation into genetic factors that may predispose infants to granuloma formation
4. Development of standardized care protocols to reduce the incidence of granulomas

How might future advancements impact the management of umbilical granulomas? As research progresses, we may see more targeted treatments, better prevention strategies, and improved outcomes for affected infants. These advancements could lead to faster healing times, reduced risk of complications, and enhanced overall care for newborns with umbilical issues.

The Role of Telemedicine in Umbilical Granuloma Care

Can telemedicine play a part in the management of umbilical granulomas? With the increasing adoption of telemedicine, healthcare providers can now offer remote consultations for initial assessment and follow-up care of umbilical granulomas. This approach can be particularly beneficial for families in rural areas or those with limited access to pediatric specialists.

Benefits of telemedicine in umbilical granuloma care include:

• Rapid access to expert advice
• Reduced need for in-person visits for minor concerns
• Improved monitoring of treatment progress
• Enhanced ability to provide timely guidance on home care

While telemedicine cannot replace hands-on treatment, it can complement traditional care methods and improve overall management of umbilical granulomas.

Umbilical Granulomas: Causes, Treatments, and Prevention

Written by WebMD Editorial Contributors

In this Article

• Causes of Umbilical Granulomas
• Impact of Umbilical Granulomas on Health
• Treating Umbilical Granulomas
• Preventing Umbilical Granuloma Infections
• When to Go to the Doctor

‌An umbilical granuloma is a small red bump of tissue that can form in a newborn’s belly button during the first several weeks after they’re born. Many babies will develop a granuloma and have no problems. However, some umbilical granulomas can become infected. In rare cases, adults can also form painful umbilical granulomas. Here’s what you need to know about how they can affect your health.

Umbilical granulomas are a type of scar tissue that forms in the belly button. Most umbilical granulomas form when the belly button is healing after the umbilical cord falls off. They look like small red lumps in your child’s navel. Unlike the rest of their skin, the granuloma will be a little shiny and covered in a clear discharge.

After the umbilical cord is cut, a small stump remains on your baby’s stomach. Typically, the stump will fall off on its own and heal without a problem. However, in rare cases, an umbilical granuloma will form where the stump fell off. Only about 1 in 500 babies will develop an umbilical granuloma.

Rarely, an adult may develop an umbilical granuloma. These lumps are caused by trauma to the bully button. One of the most common causes of an adult umbilical granuloma is navel piercing. While granulomas in babies are not painful, they may be painful for adults.

Granulomas are relatively minor complications. However, they do require treatment because they won’t resolve on their own. Most granulomas will continue to slowly grow until they’re treated. These lumps can easily become infected.‌

An infected granuloma is a critical health problem. Since granulomas are connected to the umbilical opening, infection can spread quickly. If you believe your child has an infected granuloma, reach out for medical care right away to keep the infection from getting worse.

In most cases, treating granulomas is simple. Your child’s pediatrician will probably be able to treat and remove the lump in their office. Granuloma treatments include:

Silver nitrate: Umbilical granulomas in babies don’t have nerve endings, so they can be treated with a small amount of silver nitrate. The doctor will place the silver nitrate on the granuloma, and it will burn off the tissue. Your baby will not feel any pain during the process. Adults may need a topical anesthetic to numb the area before the same treatment.

Liquid nitrogen: If silver nitrate isn’t an option, then liquid nitrogen can also be used. The liquid is very cold and freezes the lump immediately. After it’s frozen, the granuloma tissue dissolves away.‌

Suture thread ties: In some cases, your doctor may tie off the granuloma with suture thread. This cuts off blood flow to the lump. Over time, it will dry up and shrivel until it disappears.

Salt: Another way to dry out the granuloma is by using salt. Since granulomas are covered in clear mucus, the salt dries them out and causes them to shrivel away. Your doctor will give you instructions on how to apply salt to the granuloma safely.‌

Surgery: In rare cases, an umbilical granuloma may need to be surgically removed. This is most common for infected granulomas, because surgical removal is the quickest treatment. If your baby’s granuloma is infected, surgery will help stop the spread of infection and help them recover more quickly.

Since granulomas are a type of scar tissue, they’re difficult to prevent. However, if your baby develops a granuloma, you can often prevent infections.

The best way to prevent infections is to protect your baby’s belly button and keep the area clean. Gently wiping the area down with warm soap and water can prevent drainage and bacteria from building up. Your child’s doctor may have other recommendations, as well. Always follow their instructions for taking care of your baby’s navel.

All granulomas should be treated by a doctor. However, if a granuloma gets infected, it needs to be treated immediately. Your baby may need antibiotics to prevent the infection from getting worse. Signs your baby needs to go to the doctor right away include:

• ‌A fever of more than 100.4 degrees Fahrenheit
• ‌A rash around the belly button
• ‌The granuloma is bleeding
• ‌The belly button is draining a bad-smelling liquid
• ‌The area around the granuloma is swollen or red
• ‌Your baby seems to be in pain when you touch their belly button

Top Picks

Umbilical Granulomas: Causes, Treatments, and Prevention

Written by WebMD Editorial Contributors

In this Article

• Causes of Umbilical Granulomas
• Impact of Umbilical Granulomas on Health
• Treating Umbilical Granulomas
• Preventing Umbilical Granuloma Infections
• When to Go to the Doctor

‌An umbilical granuloma is a small red bump of tissue that can form in a newborn’s belly button during the first several weeks after they’re born. Many babies will develop a granuloma and have no problems. However, some umbilical granulomas can become infected. In rare cases, adults can also form painful umbilical granulomas. Here’s what you need to know about how they can affect your health.

Umbilical granulomas are a type of scar tissue that forms in the belly button. Most umbilical granulomas form when the belly button is healing after the umbilical cord falls off. They look like small red lumps in your child’s navel. Unlike the rest of their skin, the granuloma will be a little shiny and covered in a clear discharge.

After the umbilical cord is cut, a small stump remains on your baby’s stomach. Typically, the stump will fall off on its own and heal without a problem. However, in rare cases, an umbilical granuloma will form where the stump fell off. Only about 1 in 500 babies will develop an umbilical granuloma.

Rarely, an adult may develop an umbilical granuloma. These lumps are caused by trauma to the bully button. One of the most common causes of an adult umbilical granuloma is navel piercing. While granulomas in babies are not painful, they may be painful for adults.

Granulomas are relatively minor complications. However, they do require treatment because they won’t resolve on their own. Most granulomas will continue to slowly grow until they’re treated. These lumps can easily become infected.‌

An infected granuloma is a critical health problem. Since granulomas are connected to the umbilical opening, infection can spread quickly. If you believe your child has an infected granuloma, reach out for medical care right away to keep the infection from getting worse.

In most cases, treating granulomas is simple. Your child’s pediatrician will probably be able to treat and remove the lump in their office. Granuloma treatments include:

Silver nitrate: Umbilical granulomas in babies don’t have nerve endings, so they can be treated with a small amount of silver nitrate. The doctor will place the silver nitrate on the granuloma, and it will burn off the tissue. Your baby will not feel any pain during the process. Adults may need a topical anesthetic to numb the area before the same treatment.

Liquid nitrogen: If silver nitrate isn’t an option, then liquid nitrogen can also be used. The liquid is very cold and freezes the lump immediately. After it’s frozen, the granuloma tissue dissolves away.‌

Suture thread ties: In some cases, your doctor may tie off the granuloma with suture thread. This cuts off blood flow to the lump. Over time, it will dry up and shrivel until it disappears.

Salt: Another way to dry out the granuloma is by using salt. Since granulomas are covered in clear mucus, the salt dries them out and causes them to shrivel away. Your doctor will give you instructions on how to apply salt to the granuloma safely.‌

Surgery: In rare cases, an umbilical granuloma may need to be surgically removed. This is most common for infected granulomas, because surgical removal is the quickest treatment. If your baby’s granuloma is infected, surgery will help stop the spread of infection and help them recover more quickly.

Since granulomas are a type of scar tissue, they’re difficult to prevent. However, if your baby develops a granuloma, you can often prevent infections.

The best way to prevent infections is to protect your baby’s belly button and keep the area clean. Gently wiping the area down with warm soap and water can prevent drainage and bacteria from building up. Your child’s doctor may have other recommendations, as well. Always follow their instructions for taking care of your baby’s navel.

All granulomas should be treated by a doctor. However, if a granuloma gets infected, it needs to be treated immediately. Your baby may need antibiotics to prevent the infection from getting worse. Signs your baby needs to go to the doctor right away include:

• ‌A fever of more than 100. 4 degrees Fahrenheit
• ‌A rash around the belly button
• ‌The granuloma is bleeding
• ‌The belly button is draining a bad-smelling liquid
• ‌The area around the granuloma is swollen or red
• ‌Your baby seems to be in pain when you touch their belly button

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Fungus of the navel in newborns. What is the fungus of the navel in newborns?

IMPORTANT
The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Fungus of the navel in newborns is an excessive growth of granulations in the umbilical wound, which has a mushroom shape. The cause of the disease is the long-term healing of the umbilical residue with improper care, the development of simple or phlegmonous omphalitis. It looks like a pale pink or grayish rounded formation up to 1.0 cm in diameter, dense to the touch. Uncomplicated fungus proceeds without pain and discomfort. A visual inspection is sufficient for diagnosis. There are 2 treatment options: conservative (cauterization of granulations with silver nitrate solution) or surgical removal of excess connective tissue.

ICD-10

L92.8 P38

• Causes
• Pathogenesis
• Symptoms
• Complications
• Diagnostics
• Treatment of navel fungus in newborns
  • Conservative therapy
  • Surgical treatment
• Prognosis and prevention
• Prices for treatment

General

Navel fungus is a common neonatal problem that occurs in 1 in 500 babies, equally common in boys and girls. The name comes from the Latin word “fungus” (mushroom), which is due to the characteristic appearance of the formation of granulation tissue. The disease itself does not pose a threat to the health of newborns, but an atypical skin defect, which is sometimes mistaken for a tumor, causes concern for parents.

Fungus of the navel in newborns

Causes

Growth of granulations occurs as a result of a protracted healing process of the umbilical wound, due to improper skin care for newborns or inflammation of the navel. Omphalitis takes the first place among purulent-inflammatory processes in children of the first month of life, but far from always ends with the development of fungus. The risk factor is a large body weight, a wide umbilical ring.

Granulations grow in newborns with a slow wound healing process, which is caused by non-compliance with medical recommendations, late referral to the pediatrician, when omphalitis became common and turned into a phlegmonous form. There are studies confirming that the fungus of the navel is more common in post-term children or in infants with congenital pathologies and reduced body reactivity.

Pathogenesis

The formation of the navel fungus is based on the physiological process that occurs during the healing of wounds and ulcers. After the acute inflammation subsides, the edema subsides, and the umbilical wound is cleared of exudate. During this period, granulations begin to form in newborns – a young connective tissue that has a granular surface and contains a large number of capillaries. Gradually, it thickens, becomes smooth and uniform.

Normally, granulations completely fill the wound and are subsequently replaced by a scar that remains inside the navel for life. With sluggish subacute inflammation or a decrease in the regenerative abilities of the skin in newborns, an excess of granulations containing leukocytes, fibroblasts and an increased number of vessels begins to form. The formation grows outward and is not covered by the epithelium. This is how fungus is formed.

Symptoms

Fungus is distinguished by specific visual features by which parents can easily recognize it. At 2-3 weeks of life, excess granulation tissue of a grayish or pale pink color, dense in consistency, grows inside the umbilical wound in newborns. In shape, it resembles a mushroom: the main part of the tumor-like mass resembles a hemisphere, which rests on a thin stem or has a wide base. Fungus sizes vary from a few millimeters to 1 cm.

Growths do not cause discomfort in newborns. In the normal state, the fungus is painless and does not manifest itself in any way. If the formation reaches a large size, the child shows concern when swaddling or careless processing of the umbilical wound. Uncomplicated forms of the disease occur without general symptoms, do not disturb the state of health and present only an aesthetic problem.

When the fungus is complicated by microbial inflammation, redness and swelling of the skin around the navel, maceration of the surface of the granulations is observed. A cloudy liquid with an unpleasant odor is released from the wound. The baby becomes restless and often cries, eats worse, gains weight poorly. When turning over and changing a diaper, the newborn screams loudly, because touching causes pain.

Complications

The granulation tissue is very thin and delicate, therefore, with constant trauma (diaper, overalls), bacteria enter it and the inflammatory process begins. Fungus can be complicated by extensive phlegmonous inflammation, which affects not only the navel, but also the surrounding tissues. In the absence of timely treatment, the disease passes into a necrotic form.

Active bacterial inflammation of the tissues of the navel is fraught with the spread of the pathological process to the umbilical vessels with the occurrence of phlebitis and arteritis. In this case, microorganisms enter the bloodstream and can spread throughout the body. As a result, newborns with reduced immune responses are at risk of manifesting umbilical sepsis.

Diagnostics

The child is examined by a pediatrician. The fungus of the navel has pathognomonic clinical manifestations, therefore, the results of a physical examination of newborns are sufficient to make a diagnosis. Additional methods are indicated for a complicated course of the disease and the addition of a purulent infection. In such cases, the following is done:

• culture of discharge from the wound;
• general blood and urine analysis;
• Ultrasound of the soft tissues of the anterior abdominal wall.

Treatment of navel fungus in newborns

Conservative therapy

Fungus of small size is successfully treated with medicines. To destroy excess granulations, the doctor cauterizes the umbilical wound with silver nitrate. After manipulation, it is necessary to treat the navel daily with antiseptic solutions (chlorhexidine, hydrogen peroxide). It is recommended to lubricate the wound with brilliant green to prevent the ingress of microorganisms and speed up healing.

With the development of phlegmonous inflammation in the fungus area, systemic antibiotic therapy is carried out for newborns, with reduced immune reactivity, immunoglobulins may be administered. For local treatment of a purulent wound, ointments with antimicrobial components (synthomycin emulsion, levomekol) are used, which are applied to fungus 2 to 3 times a day.

Surgical treatment

In modern pediatrics, surgical intervention is resorted to in the presence of large-diameter granulation growths in newborns or in case of severe purulent complications. The fungus is removed with a scalpel, after which the wound is opened, treated with antiseptics and wound healing medicines. Necrotic inflammation requires wide excision within healthy tissues.

Prognosis and prevention

Fungus is a disease that is not dangerous to life and health, the prognosis for newborns is favorable. After removal of the overgrown granulations and healing of the navel, there is no cosmetic defect left. Complicated forms with inflammation of the phlegmonous type are of concern, in which bacterial pathogens can enter the bloodstream. The success of treatment in this case depends on the timeliness of contacting a doctor.

The basis of prevention is the correct care of the umbilical residue in the neonatal period: it is important to prevent contamination of the wound with urine or feces, wash and wipe the navel area daily, do not cover it with a diaper to allow air access, accelerating healing. Preventive measures include early detection and treatment of omphalitis in the catarrhal stage to eliminate the risk of granulation formation.

You can share your medical history, what helped you in the treatment of navel fungus in newborns.

Sources

1. Purulent-inflammatory diseases of the navel in newborns / V.N. Golovanov, A.S. Pulikov, V.O. Kin, N.I. Tolstonogov // Bulletin of the Khakass State University. N.F. Katanov. – 2015.
2. Evolution of purulent-inflammatory diseases in newborns. Abstract of the dissertation / N.I. Telyatitsky. – 2013.
3. Modern view on the pathophysiology and treatment of purulent wounds / O.E. Lutsevich, P.I. Tolstykh, O.B. Tamrazova, A.S. Pleshkov // Surgery. – 2011.
4. Treatment of umbilical granuloma in neonates/ Bolotov Iu.N., Minaev S.V., Kachanov A.V.// Medical news of North Caucasus. – 2018.
5. This article was prepared based on the site materials: https://www.krasotaimedicina.ru/

IMPORTANT
Information from this section cannot be used for self-diagnosis and self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.

Health effects of silver nitrate

Main routes of exposure

Absorption of silver nitrate is expected to occur mainly through the respiratory tract and through the digestive tract.

• Respiratory . Studies of occupationally exposed persons (determination of Ag in blood and urine) lead to the conclusion that the dust of soluble silver salts is absorbed to a greater extent than the dust of metallic silver. In addition to alveolar absorption, absorption is also possible through the mucous membranes of the nasopharynx.
• Leather . Skin contact with silver solutions results in local, largely irreversible tissue deposits.
• Digestive tract . According to the results of animal experiments, 1-10% of soluble silver salts (depending on the Ag content) are absorbed. With regard to nitrate ions, toxicokinetic studies in experimental animals, partly also in humans, have shown good absorption through the gastrointestinal tract.

Main routes of exposure

Acute toxicity

Dusts and solutions (depending on concentration) are irritating or highly corrosive to mucous membranes and skin.

Crystals in contact with eyes can cause severe inflammation and deep damage to surrounding tissues. 5-50% solutions of silver nitrate have caused severe eye damage, in some cases, permanent clouding of the cornea. A typical picture is a rapid swelling of the conjunctiva and eyelids with bloody discharge from the conjunctival sac.

Even at low concentrations, silver nitrate has a strong local caustic effect on the skin. It is used as a topical etching agent for various skin conditions. The contact points are initially white, then turn grey-black when exposed to light.

In the past, 0.5% solutions were often used therapeutically as a disinfectant and astringent. No acute local or systemic effects were observed.

No evidence of significant sensitizing potential.

Inhaled dust may cause acute respiratory irritation and possibly lung damage. However, it has been calculated that the concentrations required for this are much higher than those that cause a rapid discoloration of the eyes and mucous membranes of the nose and throat.

Intoxications have been reported in the literature as a result of accidental or suicidal ingestion of high doses of silver nitrate. Irritant and corrosive effects in the gastrointestinal tract (gastroenteritis with vomiting, diarrhea), as well as cardiovascular reactions and nervous disorders (dizziness, loss of consciousness, as well as coma, convulsions) were observed.

A dose of about 10 g has usually been fatal.

Chronic toxicity

In case of occupational exposure, brownish spots (argyria/argyrosis) can often be seen on workers.

With prolonged exposure to aerosols, localized argyrosis may result from the penetration and accumulation of small particles in the contact tissue. Generalized argyrosis requires consistent high doses. This has often been observed after long-term administration of silver nitrate solutions (to treat ulcers).

Exposure to silver nitrate and chloride at concentrations of 0.001-0.31 mg Ag/m3 for 3 to 20 years resulted in localized argyria in 8 out of 23 people. The eyes were affected (lacrimal scales, conjunctival sac of the lower eyelid), mucous membranes of the mouth and nose, and in isolated cases, the skin of the neck.

During the production of silver nitrate and oxide, argyrosis was detected in 20 out of 30 employees at exposure levels of 0.039–0.378 mg Ag/m3 and an average of 5 years of exposure. Of these, 6 people exposed for 10 years showed generalized argyria.

In addition, gastrointestinal complaints and upper respiratory tract irritation were reported in this study.

Significant systemic effects have been described only in isolated cases after long-term therapeutic use of silver nitrate (CNS disorders after a total dose of 124 g for 9 years – in this case silver deposits were found in the brain).

Reproductive toxicity, mutagenicity, carcinogenicity

• Reproductive toxicity . For silver nitrate, there are very few animal data available, which are insufficient to allow an assessment.
• Mutagenicity . Some data is available for silver nitrate and other silver salts, but not enough to make an estimate.
• Carcinogenicity . There are no studies on specific substances. There is no evidence of carcinogenic properties in long-term therapeutic use of silver nitrate.

Metabolism and excretion

According to kinetic studies, when inhaled or ingested, silver first accumulates, especially in the liver. It is excreted slowly, mainly with feces, in small amounts with urine. Most of it remains in the body.

Silver partially binds in tissues as chloride or phosphate, but can be released again from these salts and immobilized by the formation of silver sulfide, which causes irreversible discoloration of tissues.

Larger portions of the retained amount are bound as silver albuminate, distributed in the blood and lymph and also converted to silver sulfide in the tissues.

Storage in organs is limited to connective tissue, cells of specific organs are not affected.

Silver is not an essential element for the human body. It reduces the activity of copper and selenium , which are essential for metabolism. The possibility of health disorders in case of insufficient intake of these microelements and exposure to soluble silver salts is indicated.

First Aid

• Eyes . Rinse eyes under running water for 10 minutes with eyelids wide open, protecting intact eye. Then take it to the doctor as soon as possible.
• Leather . Remove with a brush the dust that is visible on the skin. Then wash the skin thoroughly with plenty of soap and water. After contact with solutions: remove wet clothing, rinse the affected skin under running water for at least 10-20 minutes. Seek medical attention.
• Breathing system . Take the victim out of the danger area and into fresh air. Give glucocorticoid metered dose inhalation as soon as possible, give oxygen if breathing is difficult. Take the victim to the hospital.
• If swallowed . Rinse your mouth, spit out the liquid. Immediately ask the person to drink 1 glass of water (approximately 200 ml). It is better to immediately give a saline solution (1 teaspoon of table salt dissolved in a glass of water). If possible, also give a glass of milk to drink. Spontaneous vomiting is likely: tilt the head of the victim into a prone position so that the contents of the stomach do not enter the trachea. Take the victim to the hospital.

Information for the physician

Symptoms of acute poisoning

Silver nitrate in the form of crystalline dust or aqueous solution has an astringent, irritating, corrosive effect on the mucous membranes and skin, depending on the dose or concentration.