doiSerbia

Fatal consequences caused by prolonged chloroform inhalation in a child

Milić Miroslav (Department of Forensic medicine Niš + Faculty of Medicine, Niš)
Antović Aleksandra (Department of Forensic medicine Niš + Faculty of Medicine, Niš)
Trandafilović Milena (Faculty of Medicine, Niš + Faculty of Medicine, Institute of Anatomy, Niš)
Zdravković Miodrag (Department of Forensic medicine Niš + Faculty of Medicine, Niš)

Introduction. Chloroform intoxication as a result of inhalation is usually associated with occupational exposure. Fatal cases of accidental and intentional chloroform poisoning are extremely rare. The aim of this work was to report a case with fatal consequences caused by prolonged chloroform inhalation in a child. Case outline. We report a case of a three-month-old child found dead by its mother in their home. Investigation provided the data about two refrigerators in the house, which were not entirely functional, and were filled with a refrigerant based on chloroform, and about a recent house spraying with a pesticide also based on chloroform. Forensic autopsy was performed the following day. Autopsy established the existence of malnutrition, dehydration, brain and lungs edema, the presence of very scarce contents in the digestive tract, and the enlargement of the abdominal lymph nodes. The initial stage of liver degeneration was noted on histopathological examination. Chemical-toxicological analysis of organ tissue samples (brain, lungs, spleen, liver with gall bladder, kidney and bladder, stomach, small and large intestine) performed using the techniques of headspace gas chromatography with mass detector, confirmed chloroform poisoning. Conclusion. The emaciation underlying the dysfunction of organ systems provided a grim frame for a child to succumb to chloroform toxicity. The proper use and maintenance of domestic appliances, and careful application of chemical agents indoors is an imperative, especially in the vicinity of children. Low levels of chloroform inhaled from the room air may have fatal consequences in a susceptible individual.

Keywords: chloroform, intoxication, toxicology, autopsy, forensic pathology