Medico-legal Analysis of a Case of Fatal Hypothermia: Risk Factors and the Importance of the Autopsy Findings
DOI:
https://doi.org/10.48165/jfmt.2026.43.02.25Keywords:
Hypothermia, Wischnewsky spots, autopsy, forensic pathology, frost bitesAbstract
We present the case of L.R., an 82-years-old woman who was found dead in her house, with history of psychiatric disease and hard palate cancer. At the examination of the scene of death she was found under a closet in her bedroom, lying on the ground completely naked. The body showed initial signs of putrefaction: discoloration of the lower abdominal wall and insects’ eggs on the eyelids. Natural death due to the neoplasia, asphyxia due to confinement, neglect, psychiatric drugs overdose or homicide were considered all plausible causes of death. A full autopsy was carried out, showing advanced cachectic state, presence of larvae inside the mouth, neoformation on the left hard palate, small excoriations on the right upper limb, acrocyanosis and frost bites on the distal phalanges of both hands, discoloration of the lower thoracic and abdominal walls, fine reddish spotting of liver, lungs, spleen and uterus. Moreover, the gastric mucosa showed numerous black hemorrhagic spots, histologically diagnosed to be "Wischnewsky spots". Toxicological analyses were negative for drug use or abuse. The combination of these pathological findings and circumstantial evidence led to identifying a condition of fatal hypothermia as the cause of death. This case showed the importance of a full autopsy together with the study of clinical records and circumstantial evidence in the distinction between different plausible causes of death which is useful not only in medico-legal practice but also in the collection of epidemiological data
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