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Unusual Presentation of Death Due to Carbon Monoxide Poisoning: A Report of Two Cases

Ruszkiewicz, Andrew M.D.; de Boer, Bastiaan F.R.C.P.A.; Robertson, Shelley F.R.C.P.A.

The American Journal of Forensic Medicine and Pathology: June 1997 - Volume 18 - Issue 2 - p 181-184

Two cases are reported representing opposite ends of the spectrum of death as a result of carbon monoxide poisoning from car exhaust fumes. In one case, a woman was reported to be found dead in bed early in the morning by her husband. The cause of her death, established by autopsy, was carbon monoxide poisoning. Toxicology examination indicated a car engine as the source of carbon monoxide. The mode of administration was never established. In the second case, a woman was found in a car located in her garage with a hose leading from the exhaust pipe to the interior of the sealed vehicle. Autopsy revealed negligible carboxyhemoglobin saturation of the blood, bilateral infarction of the globus pallidus, and extensive bronchopneumonia. It was concluded that inhalation of carbon monoxide resulted in sublethal hypoxia with subsequent exhalation of carbon monoxide and a delayed death.

From the Institute of Medical and Veterinary Science, Adelaide, Royal Perth Hospital, Perth, and the Victorian Institute of Forensic Pathology, Melbourne, Australia.

Address correspondence and reprint requests to Dr Andrew Ruszkiewicz, Institute of Medical and Veterinary Science, Tissue Pathology, PO Box 14 Rundle Mall, Adelaide 5000, South Australia.

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