A patient was found to have pink coloured skin and mucosa, bitter almond smell from breath and frothy discharge. Cause of death in this patient;
The above findings are suggestive of Cyanide poisoning Cyanide poisoning - Ideal suicidal poison (most rapid when inhaled) Cyanide is a rapidly acting, potentially deadly chemical that can exist in various forms. Cyanide can be a colourless gas, such as hydrogen cyanide (HCN) or cyanogen chloride (CNCl), or a crystal form such as sodium cyanide (NaCN) or potassium cyanide (KCN). Cyanide is released from natural substances in some foods and in ceain plants such as cassava, linseed plant, lima beans and almonds, apricots, apples, and peaches Cyanide inhibits Cytochrome oxidase leading to histotoxic Anoxia Signs and Symptoms: C.N.S.: Headache, veigo, faintness, perspiration, anxiety, excitement, confusion, drowsiness, prostration, opisthotonus and trismus, cramps, twitching, hypehermia, convulsions, paralysis, stupor, coma, and death. G.I.T.: Bitter, acid, burning taste, constriction or numbness of throat, salivation, nausea, rarely vomiting. R.S.: Odour of bitter almonds in breath. Initially tachypnoea and dyspnoea due to cyanide stimulation of chemoreceptors and the respiratory centre. Later rapid slowing of respiratory rate with severe respiratory depression and cyanosis. Frothy discharge from mouth C.V.S.: Initially hypeension with reflex bradycardia, sinus arrhythmia. Later tachycardia with hypotension and cardiovascular collapse. Skin: Perspiration, bullae. Pink coloured skin and mucosa Eyes: Glassy and prominent, pupils dilated, unreactive. Renal: Acidosis. Death occurs from respiratory failure. Fatal Period: 2 to 10 minutes; sometimes immediate. Potassium or sodium cyanide: half an hour. The patient may survive for several hours due to delayed absorption. Management - Lilly's antidote Vit. B12 Di cobalt EDTA Bright/Brick Red hypostasis is seen after death of patient Bedside test for Cyanide - Lee jones test
Cyanide poisoning
CO poisoning
H2S poisoning
Datura poisoning
FMGE 2019