Homicide with intramuscular cyanide injection: a case report
AbstractCyanide poisoning most commonly occurs from smoke inhalation, less commonly by oral ingestion for suicide or homicide. There are rare cases of intravenous or subcutaneous parenteral cyanide. We report a fatal case of intramuscular cyanide used as a homicidal agent. A 35-year-old female was a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Toxicology Communications |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/24734306.2021.2015550 |
| _version_ | 1797805352740192256 |
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| author | Natasha Tobarran Emily K. Kershner Kirk L. Cumpston S. Rutherfoord Rose Brandon K. Wills |
| author_facet | Natasha Tobarran Emily K. Kershner Kirk L. Cumpston S. Rutherfoord Rose Brandon K. Wills |
| author_sort | Natasha Tobarran |
| collection | DOAJ |
| description | AbstractCyanide poisoning most commonly occurs from smoke inhalation, less commonly by oral ingestion for suicide or homicide. There are rare cases of intravenous or subcutaneous parenteral cyanide. We report a fatal case of intramuscular cyanide used as a homicidal agent. A 35-year-old female was assaulted and injected with an unknown substance in her left buttock using a syringe. She was unresponsive at ED arrival and underwent immediate endotracheal intubation. After near normal vital signs at arrival (BP 130/83 mmHg, HR 102 bpm), she rapidly became hypotensive and bradycardic with worsening acidosis (pH 6.95, lactate 7.7 mmol/L). Despite vasopressors, hydroxocobalamin, and sodium thiosulfate, she succumbed. Plasma cyanide concentrations from blood drawn 1 and 4 h post exposure were both in the lethal range (3.4 and 4.1 mg/L, respectively). Our case demonstrates that intramuscular injection can result in fatal cyanide poisoning, resulting in rapid absorption, severe toxicity, and death. |
| first_indexed | 2024-03-13T05:50:48Z |
| format | Article |
| id | doaj.art-582be7c727274451af4a3361ec6fbbe9 |
| institution | Directory Open Access Journal |
| issn | 2473-4306 |
| language | English |
| last_indexed | 2024-03-13T05:50:48Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Toxicology Communications |
| spelling | doaj.art-582be7c727274451af4a3361ec6fbbe92023-06-13T12:55:24ZengTaylor & Francis GroupToxicology Communications2473-43062022-12-0161202210.1080/24734306.2021.2015550Homicide with intramuscular cyanide injection: a case reportNatasha Tobarran0Emily K. Kershner1Kirk L. Cumpston2S. Rutherfoord Rose3Brandon K. Wills4Division of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, USADivision of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, USADivision of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, USADivision of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, USADivision of Clinical Toxicology, Department of Emergency Medicine, VCU Medical Center, Richmond, VA, USAAbstractCyanide poisoning most commonly occurs from smoke inhalation, less commonly by oral ingestion for suicide or homicide. There are rare cases of intravenous or subcutaneous parenteral cyanide. We report a fatal case of intramuscular cyanide used as a homicidal agent. A 35-year-old female was assaulted and injected with an unknown substance in her left buttock using a syringe. She was unresponsive at ED arrival and underwent immediate endotracheal intubation. After near normal vital signs at arrival (BP 130/83 mmHg, HR 102 bpm), she rapidly became hypotensive and bradycardic with worsening acidosis (pH 6.95, lactate 7.7 mmol/L). Despite vasopressors, hydroxocobalamin, and sodium thiosulfate, she succumbed. Plasma cyanide concentrations from blood drawn 1 and 4 h post exposure were both in the lethal range (3.4 and 4.1 mg/L, respectively). Our case demonstrates that intramuscular injection can result in fatal cyanide poisoning, resulting in rapid absorption, severe toxicity, and death.https://www.tandfonline.com/doi/10.1080/24734306.2021.2015550Cyanidetoxicityintramuscularinjectionhydroxocobalaminfatality |
| spellingShingle | Natasha Tobarran Emily K. Kershner Kirk L. Cumpston S. Rutherfoord Rose Brandon K. Wills Homicide with intramuscular cyanide injection: a case report Toxicology Communications Cyanide toxicity intramuscular injection hydroxocobalamin fatality |
| title | Homicide with intramuscular cyanide injection: a case report |
| title_full | Homicide with intramuscular cyanide injection: a case report |
| title_fullStr | Homicide with intramuscular cyanide injection: a case report |
| title_full_unstemmed | Homicide with intramuscular cyanide injection: a case report |
| title_short | Homicide with intramuscular cyanide injection: a case report |
| title_sort | homicide with intramuscular cyanide injection a case report |
| topic | Cyanide toxicity intramuscular injection hydroxocobalamin fatality |
| url | https://www.tandfonline.com/doi/10.1080/24734306.2021.2015550 |
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