A. Characteristic bitter lemon smell.
B. Congested organs.
C. Distinct odor of bitter almonds.
D. Erosion and hemorrhages in esophagus and stomach.
Ans:A. Characteristic bitter lemon smell.
The poisoning case shown in the picture above represents HCN poisoning as lividity shown is bright red(pinkish red) staining.
- Acute hydrogen cyanide poisoning can result from inhalation of fumes from burning polymer products that use nitrile in their production, such as polyurethane, or vinyl.
Cyanides are used in many industries and thus are available to potential poisoners.
- The main industries that use cyanides are:Mining of gold and Silver,Electroplating industry,pesticide industry
- Cyanide poisoning is a form of histotoxic hypoxia because the cells of an organism are unable to create ATP, primarily through the inhibition of the mitochondrial enzyme cytochrome c oxidase.
- Autopsy Findings
Hypostasis is said to be brick-red, due to excess oxyhaemoglobin (because the tissue are prevented from using oxygen) and to the presence of cyanmethaemoglobin.
There may be a smell of cyanide about the body, and a distinct odor of bitter almonds about the viscera especially in the skull cavity and the brain.
Internally the tissues may also be bright pink caused by the oxyhaemoglobin that cannot be utilized by the tissues – which is probably more common than the presence of cyanmethaemoglobin.
The stomach lining may be badly damaged and can present a blackened, eroded surface, by altered blood staining the stripped mucosa.The oesophagus may be damage, especially the mucosa of the lower third.
|CO poisoning||Cyanide poisoning|
|Effect on ability of RBCs to transfer Oxygen||Yes,it impairs||No|
|Effect on mitochondria||Effect not as much as Cyanide poisoning||Complete and sustained blockade of cellular respiration inducing severe lactic acidosis|
|Type of Hypoxia||Hypemic hypoxia is caused by the reduction of the oxygen carrying capacity of the blood.||Histotoxic hypoxia because the cells of an organism are unable to create ATP, primarily through the inhibition of the mitochondrial enzyme cytochrome c oxidase.|
|Amount of exposure required||Requires hours of exposure||Occurs within seconds or minutes of exposure|
|Post-mortem lividity Colour||Cherry red||Pinkish red|
|Treatment||Oxygen||Oxygen with Antidote like amyl nitrite,intravenous sodium nitrite, intravenous sodium thiosulfate and Hydroxocobalamin|