title: Death due to ingestion of nicotine-containing solution: case report and review of the literature.
abstract: Nicotine, a lipid-soluble alkaloid obtained from the dried leaves of Nicotiana, is most frequently encountered in tobacco products for smoking, chewing or sniffing as well as in a limited number of pesticides. Though nicotine is one of the most toxic drugs of abuse, it has rarely led to fatalities. Sudden death can be caused by cardiovascular arrest, respiratory muscle paralysis and/or central respiratory failure. A 42-year-old man was found dead by his wife. He was lying on the floor, next to a box containing many empty bottles of beer and vodka. Some labeled chemical bottles found at the scene contained various substances, including nicotine and brucine. Gross examination of the organs at autopsy revealed no specific findings. The toxicological examination failed to disclose any lethal toxic agents other than a high concentration of nicotine and its primary metabolite cotinine in femoral venous blood (2.2 microg/mL). Blood alcohol was determined to be 2.1 g/L in femoral venous blood. Only a paucity of fatal cases of nicotine poisoning has been reported in the literature so far.
authors: Department of Internal Medicine and Public Medicine, University of Bari, Bari, Italy. bisola@tin.it
authors: Biagio
authors: B
authors: Solarino
authors: Frank
authors: F
authors: Rosenbaum
authors: Benno
authors: B
authors: Riesselmann
authors: Claas T
authors: CT
authors: Buschmann
authors: Michael
authors: M
authors: Tsokos
mesh_terms: D000328:Adult; D000700:Analgesics / Q000032:analysis; D002492:Central Nervous System Depressants / Q000097:blood; D003367:Cotinine / Q000097:blood; D000431:Ethanol / Q000097:blood; D053593:Forensic Toxicology; D005731:Ganglionic Stimulants / Q000032:analysis / Q000506:poisoning*; D008401:Gas Chromatography-Mass Spectrometry; D005766:Gastrointestinal Contents / Q000737:chemistry; D006801:Humans; D008297:Male; D009538:Nicotine / Q000032:analysis / Q000506:poisoning*; D013331:Strychnine / Q000031:analogs & derivatives / Q000032:analysis
chemical_list: D000700:Analgesics; D002492:Central Nervous System Depressants; D005731:Ganglionic Stimulants; D000431:Ethanol; D009538:Nicotine; C083806:brucine; D013331:Strychnine; D003367:Cotinine