title: A case of extreme agitation and death after the use of mephedrone in The Netherlands.
abstract: A 36-year old man, having injured himself severely by smashing windows in a rage of fury, was arrested by the police. He died despite resuscitation attempts. The forensic autopsy showed many superficial skin lacerations, bruises and minor brain swelling, but there was no definitive cause of death. Toxicological analysis showed a high concentration of mephedrone in femoral blood (5.1mg/L) and traces of cocaine, MDMA and oxazepam. The remaining dose of mephedrone in the stomach contents was estimated at 113 mg. Tablets that were found in the house of the deceased also contained mephedrone. We attribute this man's death to a fatal oral intake of mephedrone, which probably led to a state of excited delirium. This was aggravated by blood loss from multiple wounds.
authors.affiliation: Department of Pathology and Toxicology, Netherlands Forensic Institute, Laan van Ypenburg 6, 2497GB The Hague, The Netherlands. k.lusthof@nfi.minjus.nl
authors.forename: Klaas J
authors.initials: KJ
authors.lastname: Lusthof
authors.forename: Roelof
authors.initials: R
authors.lastname: Oosting
authors.forename: Ann
authors.initials: A
authors.lastname: Maes
authors.forename: Miranda
authors.initials: M
authors.lastname: Verschraagen
authors.forename: Albert
authors.initials: A
authors.lastname: Dijkhuizen
authors.forename: Annette G A
authors.initials: AG
authors.lastname: Sprong
mesh_terms: D000328:Adult; D001929:Brain Edema / Q000473:pathology; D000697:Central Nervous System Stimulants / Q000032:analysis / Q000506:poisoning*; D003042:Cocaine / Q000097:blood; D003288:Contusions / Q000473:pathology; D003693:Delirium / Q000139:chemically induced*; D015198:Designer Drugs / Q000032:analysis / Q000506:poisoning*; D053593:Forensic Toxicology; D005766:Gastrointestinal Contents / Q000737:chemistry; D006470:Hemorrhage / Q000473:pathology; D006801:Humans; D022125:Lacerations / Q000473:pathology; D008297:Male; D008694:Methamphetamine / Q000031:analogs & derivatives* / Q000032:analysis / Q000506:poisoning; D008874:Midazolam / Q000097:blood; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000097:blood; D009294:Narcotics / Q000097:blood; D009426:Netherlands; D010076:Oxazepam / Q000097:blood; D011889:Rage; D012867:Skin / Q000293:injuries / Q000473:pathology
chemical_list: D000697:Central Nervous System Stimulants; D015198:Designer Drugs; D009294:Narcotics; D008694:Methamphetamine; D010076:Oxazepam; C548233:mephedrone; D003042:Cocaine; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D008874:Midazolam