RESUMO
A female in her twenties was found dead in her room. She had received medications for depression and panic disorder, and had attemped suicide several times. Many packets of prescribed drugs, including paroxetine, were found near the corpse. At autopsy, the lungs were edematous. The organs were slightly congested with putrefactive change. Autolytic rupture, considered as gastromalasia, was observed in the anterior cardiac portion of stomach wall. Toxicological examination revealed 0.78, 3.20 and 17.63 microg/ml of paroxetine in the heart blood, femoral blood and urine, respectively. Acetaminophen and phenobarbital were also identified within therapeutic or sub-lethal levels. Taking into consideration postmortem diffusion of drugs, we evaluated postmortem data and concluded that the death was mainly due to toxicity of paroxetine with serotonin syndrome.
Assuntos
Antidepressivos de Segunda Geração/intoxicação , Paroxetina/intoxicação , Inibidores Seletivos de Recaptação de Serotonina/intoxicação , Suicídio , Autopsia , Feminino , Humanos , Adulto JovemRESUMO
We present here a case of sepsis due to infectious endocarditis in a methamphetamine abuser. A 32 year-old male presented high fever and abdominal pain last two weeks. He was admitted to the hospital on the diagnosis of infectious endocarditis. In the evening on the day of admission, he suddenly collapsed. Despite of cardiopulmonary resuscitation, his death was confirmed. From the autopsy findings, toxicological analysis and results of the microbiological examination, we concluded that the cause of death was septic shock due to infectious endocarditis, presumably based on the methamphetamine abuse. The result obtained from microbiological examination gave us useful information. We shall have to be on the lookout, not only for acute poisoning, but also for cases of drug abuse related deaths.
