Toxicological Investigation of Acute Cyanide Poisoning of a 29-year-old Man: A Case Report

Background: Cyanide poisoning is frequently lethal, Because of the early onset of severe symptoms and difficulty in the diagnosis. Case: The case was a 29-year-old boy who collapsed suddenly after taking a bottle of beer in a bar. Samples, such as peripheral blood, stomach contents, bile fluid, urine and mouth swabs, were prepared using standard autopsy procedure and were subjected to analysis for cyanide using visible spectrophotometric method. The cyanide contents in samples, included stomach content (260 ppm), bile fluid (272 ppm), blood (256 ppm), and mouth swab (265 ppm). Conclusion: The cause of death was acute myocardial infarction following acute poisoning from ingestion of cyanide salts. Its lethality was related to the rapid onset of toxicity, non-specific nature of the symptoms, and failure to consider the diagnosis. Regarding the absence of pathognomonic symptoms for its toxicity, delay in acquiring a full history and unexplained sudden collapse or acidosis which worsen the prognosis, cyanide intoxication needs to be expeditiously diagnosed and managed.