Citation

Tambuzzi S, Gentile G, Andreola S, Migliorini AS, Zoja R. Acad. Forensic Pathol. 2022; 12(3): 118-125.

Copyright

(Copyright © 2022, National Association of Medical Examiners)

DOI

10.1177/19253621221119081

PMID

36093372

PMCID

PMC9459401

Abstract

Lysoform® in the formulation of professional detergent is widely used in several fields, whereas its suicidal ingestion is an unusual occurrence. Therefore, the biological signs of this fatal poisoning remain unclear and elusive, similarly to the histological lesions induced by its main constituent, which is benzalkonium chloride (BZK). Furthermore, since all the deaths that has been reported in the literature occurred immediately, microscopic pictures of BZK lethal toxicity in subjects with prolonged survival have never been reported to date. Specifically, this brief communication reports the unique case of a woman who ingested professional Lysoform® to commit suicide, for which she died two weeks later. The autopsy examination showed either local or systemic signs of caustic ingestion; moreover, the histological analysis showed clear cellular damage of lungs, heart, and kidneys. In our case, toxicological investigations were not authorized as they were no longer considered significant. In this framework, the histological examination has therefore assumed a fundamental role in investigating and demonstrating the lethal effects caused by the systemic dissemination of BZK, which would otherwise no longer be investigable. Therefore, in cases of substance intoxication with prolonged survival where forensic toxicological investigations may be no longer possible or feasible, the histological examination may be the only resource to successfully observe and demonstrate its lethal effects.

Language: en

Keywords

Forensic autopsy; Forensic pathology; Benzalkonium chloride; BZK; Professional Lysoform®; Suicidal ingestion