title: Histopatholological Findings in a Fatal Case of Rinkhals Envenomation: A New Forensic Pathology Finding?
abstract: Although cobra envenomation continues to pose a threat to life and therefore constitutes a major cause of death in Africa, India, and Sri Lanka, the forensic pathology reports are not always histologically well documented or illustrated. The reports in the literature, although providing graphic evidence of the macroscopic appearances of the bite and its ensuing tissue necrosis, should the victim survive, often do not illustrate the histopathological findings to a sufficient degree. We present an unusual case of fatal envenomation by a rinkhals (Hemachatus haemachatus) in which the victim had been bitten a second time after a previous rinkhals' bite. Two issues therefore arose: (a) whether the histopathological findings in the spleen were an acute reaction to the snake bite or were due to immunostimulation as a consequence of the previously inflicted bite, and (b) the previously undocumented finding of extravasation of erythrocytes into the surrounding Virchow-Robin spaces in the brain, a finding usually associated with blunt head trauma and therefore interpreted as a cortical contusion hemorrhage by forensic pathologists.
authors.affiliation: From the *Division of Forensic Medicine and Pathology, and †Department of Chemical Pathology and Toxicology Unit, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Jacob Joseph
authors.initials: JJ
authors.lastname: Moar
authors.forename: Lawrence
authors.initials: L
authors.lastname: Hill
authors.forename: Michael
authors.initials: M
authors.lastname: Stewart
mesh_terms: D000818:Animals; D001921:Brain / Q000473:pathology; D004211:Disseminated Intravascular Coagulation / Q000209:etiology; D004912:Erythrocytes / Q000473:pathology; D049429:Forensic Pathology; D006801:Humans; D007114:Immunization; D008297:Male; D012909:Snake Bites / Q000473:pathology*; D012910:Snake Venoms / Q000506:poisoning*; D013154:Spleen / Q000473:pathology; D055815:Young Adult
chemical_list: D012910:Snake Venoms