Death by acute alcohol poisoning in a 27-year-old female patient. Autopsy confirmed the cause of death.
A 27-year-old female drank approximately 450 mL of Hennessy cognac (with an ethanol content of 40%) during one night. Then, during the same night, she went to meet another group of people, where she consumed another 150 mL of spirit (with an ethanol content of 35%). Subsequently, she went into coma after drinking this much alcohol. Thereafter, some people brought her to the hospital.
The physician on duty started her on intravenous fluids. However, the woman succumbed to death. According to the history and clinical picture, the physician reported that the alcohol consumed by the woman before slipping into coma halted her heart and breathing. By the time when she reached the hospital, her carotid pulse was no longer palpable.
An autopsy was performed to confirm the cause of death. The post-mortem external examination revealed cyanosed face, lips, and fingernails bilaterally. Moreover, the examiner also noticed needle marks on the dorsum of her left hand which were due to medical treatment.
Internal examination showed pale-red edematous fluid in the alveolar spaces which suggested a diagnosis of pneumo-oedema secondary to alcohol consumption. A toxicology report of the central blood revealed a blood alcohol level (BAC) of 3.33 mg/mL.
Blood tests (monoclonal antibody board test) for morphine, pethidine, cocaine, marijuana, ketamine, methadone, amphetamine and methamphetamine were negative.
With the history and the autopsy findings, the patient’s cause of death was consistent with acute alcohol poisoning. This is other words means the death occurred due to consumption of large amounts of alcohol in a short period of time.
Mild to moderate cases may be manageable with supportive management. It is imperative to avoid and manage dehydration, hypothermia, hypotension, hypoglycemia, and respiratory depression. Moreover, it is crucial to correct the electrolyte abnormalities and metabolic acidosis. Comatose patients may require endotracheal intubation and artificial ventilation. Severe cases may lead to death as seen in this patient.
Wang H, Xu H, Li W, Li B, Shi Q, Ma K, Xiao B, Chen L, Forensic appraisal of death due to acute alcohol poisoning: three case reports and a literature review, 2019; 341-347 https://doi.org/10.1080/20961790.2019.1572259