title: Sudden Death Due To Acute Cocaine Toxicity-Excited Delirium in a Body Packer.
abstract: Excited delirium denotes a life-threatening medical condition characterized by the acute onset of agitated and violent behavior that often results in a sudden and unexplained death. Cocaine-induced excited delirium refers to fatal cocaine intoxication with the following symptoms occurring sequentially: hyperthermia, delirium with agitation, respiratory arrest, and death. We present a case of cocaine-induced excited delirium in a cocaine "body packer" or a "mule", specifically an individual who attempts to smuggle cocaine within the body. Investigators at the scene initially suspected homicide due to the victim's sharp and blunt force injuries. Three rubber packets containing cocaine were removed from the victim's rectum. Blood toxicological analysis revealed an alcohol concentration of 0.016 g/100 and cocaine >1 mg/L. The forensic pathologist should consider cocaine-induced excited delirium when an individual exhibits aggressive behavior, unexpected strength, and resistance to pain who dies suddenly. Further analysis should be performed during the scene investigation and autopsy for evidence of body packing.
authors: Norton Neuroscience Institute, Norton Healthcare, 210 East Gray Street, Suite 1102, Louisville, KY 40202.
authors: Lisa B E
authors: LB
authors: Shields
authors: State Medical Examiner Office, 5455 Dr. Martin Luther King Ave., Anchorage, Alaska 99507.|Office of the Associate Chief Medical Examiner, KY Justice and Public Safety Cabinet, 100 Sower Blvd, Ste 202, Frankfort, KY 40601-8272.
authors: Cristin M
authors: CM
authors: Rolf
authors: Office of the Associate Chief Medical Examiner, KY Justice and Public Safety Cabinet, 100 Sower Blvd, Ste 202, Frankfort, KY 40601-8272.|Department of Pathology and Laboratory Medicine, University of Kentucky College of Medicine, 100 Sower Blvd, Ste 202, Frankfort, Lexington, KY 40601-8272.
authors: John C
authors: JC
authors: Hunsaker
mesh_terms: D000328:Adult; D000075066:Body Packing; D003042:Cocaine / Q000009:adverse effects*; D003645:Death, Sudden / Q000209:etiology*; D003693:Delirium / Q000139:chemically induced*; D006801:Humans; D008297:Male; D009294:Narcotics / Q000009:adverse effects*
chemical_list: D009294:Narcotics; D003042:Cocaine
keywords: body packer; cocaine; excited delirium; forensic pathology; forensic science; sudden death