A rare fatal case of self-poisoning with nitrobenzene following oral ingestion is reported. On presentation to the hospital, severe methemoglobinemia (70%) was observed in an 82-year-old male who had ingested 250 mL of an unknown substance in the previous 24 h. Methylene blue and exchange transfusion were the therapeutic methods applied in the treatment of the methemoglobinemia. Forty-eight hours after ingestion, a blood sample was collected in ICU and sent to our laboratory. We detected that the blood contained 3.2 microg/mL of nitrobenzene. The determination of nitrobenzene was performed using the combination of GC-FID for screening analysis and quantitation and GC-MS for confirmation of the obtained results.

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The purpose of this paper is to report a case of fluoride poisoning along with a discussion of poisoning characteristics, analytical procedures, and a review of previous reports of fatal intoxications with analytical data. A case of suicidal ingestion of 40 mL of a rust removal agent containing hydrofluoric acid and ammonium fluoride by a 33-year-old white male is presented. He had an organic personality disorder with residual schizophrenia and previous suicide attempts with therapeutic drugs and cleaning products. At admission, he presented with a Glasgow coma score of 3, third degree atrioventricular block, and asystole. Resuscitation efforts were performed during which the patient suffered two episodes of ventricular fibrillation followed by asystole. In spite of advanced resuscitation efforts and the administration of calcium chloride, he died 2.5 h after the ingestion. Analytical data in the hospital showed calcium levels of 3.1 mg/dL and metabolic acidosis. Internal findings were erosive gastritis, brain edema, and pulmonary and hepatic congestion. Quantitation of fluoride was performed using an ion-selective electrode for the anion. Disposition of fluoride in the different tissues was as follows: peripheral blood, 19.4 mg/L; urine, 670 mg/L; vitreous humor, 2.5 mg/L; liver, 40.0 mg/kg; kidney, 60.0 mg/kg; lung, 17.5 mg/kg; brain, 2.5 mg/kg; spleen, 30.0 mg/kg; bone, 0.5 mg/ kg; and gastric content, 1120 mg/L (67 mg total). Validation of the analytical method was performed using different spiked tissues, in a range of concentrations from 2.4 to 475 mg/L or mg/kg, and submitting them to dilution (1:25) to avoid the matrix effect and to bring these concentrations to the range of the aqueous calibration curve (0.19-19 mg/L). Limits of detection and quantitation were 0.02 and 0.1 mg/L, respectively. The linearity of the method, for all studies tissues, was excellent, with r(2) values of 0.999. Accuracy and precision were within 10.5% and 5.7%, respectively. Fluoride analyses using the ion selective electrode are simple, sensitive, and rapid. This report provides an extensive tissue distribution study of fluoride after a well documented case of acute poisoning. Based on the autopsy findings, patient history, toxicology results, and previously reported data the forensic pathologists ruled that the cause of death was due to a fluoride poisoning, and the manner of death was listed as suicide.

This is the largest report of benzydamine ingestions. The outstanding feature was the high percentage of neurological manifestations in children and adults, mainly hallucinations, following the ingestion of an over-the-counter product.

This report documents a case of drug-facilitated sexual assault (DFSA) under the influence of solvents. The victim was a 13-year-old female. Upon contact with law enforcement, she was still confused and could hardly explain the facts. She told authorities that she had been kidnapped 4 h previously when two individuals with covered faces put a cloth soaked in a solvent over her mouth. She spent a few hours in a room, during which she lost consciousness. The girl awakened semi-nude in the street with memory loss. No alcohol was present in the subject's body; no odor of alcohol was detected on the subject's breath. No lesions were observed during a gynecological exam. A blood sample was taken with the intent to investigate the use of chloroform or similar anesthetics. Toxicological analysis of the victim's blood revealed the presence of 7.6 mg/L of benzene, 24.8 mg/L of toluene, and 0.6 mg/L of xylene (mixture of isomers). As for other analytical findings, diazepam (0.02 mg/L) was also found. The aromatic solvents involved in this case were detected using gas chromatography with flame-ionization detection (GC-FID) and confirmed using GC-mass spectrometry (MS) in full scan mode after liquid-liquid extraction of the whole blood sample. Quantitation of the aromatic solvents was carried out using GC-FID. Diazepam was detected using GC with nitrogen-phosphorus detection (NPD) and confirmed using GC-MS with full scan mode after solid-phase extraction of the whole blood sample using Bond-Elut Certify columns. Quantitation of diazepam was carried out using GC-NPD. No other drugs, including ethanol, were detected. Recoveries for benzene, toluene, and xylene (mixture of isomers) in whole blood at 5 mg/L were 89.2%, 90.8%, and 93.4%, respectively. Intraday precisions were 5.3%, 5.0%, and 4.9%, respectively, and interday precisions were 12.1%, 11.6%, and 11.5%, respectively. The limits of detection (LOD) and quantitation (LOQ) were 30 and 100 microg/L, respectively. The linearity of the blood calibration curves was excellent with r(2) values of> 0.999 (range 0.1-10 mg/L). Recovery for diazepam in whole blood at 0.5 mg/L was 88.2% with intraday and interday precisions of 2.0% and 10.8%, respectively. The LOD and LOQ were 6 and 20 microg/L, respectively. The linearity of the blood calibration curve was excellent with r(2) values of > 0.999 (range 0.1-2 mg/L). We want to alert other toxicologists about new or unexpected products that should be taken into account when the surreptitious use of substances in DFSA is suspected.