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Deaths from Extremes of Temperature

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Essentials of Autopsy Practice

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Abstract

Deaths associated with exposure to high and low environmental temperatures are common, but can present problems to the pathologist because of the relative lack of diagnostic findings at autopsy. Where a clinical recording of temperature has been made, then the diagnosis will often be self-evident. In other cases, the suspicion of a death from extremes of temperature will be raised by the circumstances of the death and knowledge of the environmental temperature. As well as the effects of the environmental temperature, hypothermia and hyperthermia may be the result of natural disease and use of certain drugs.

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References

  1. Guyton AC, Hall JE. Body temperature, temperature regulation, and fever. In: Medical physiology. 10th ed. Philadelphia: WB Saunders; 2000. p. 822–33.

    Google Scholar 

  2. Danzl DF, Pozos RS. Accidental hypothermia. N Engl J Med. 19

    Article  PubMed  CAS  Google Scholar 

  3. Danzl DF. Accidental hypothermia. In: Auerbach PS, editor. Wilderness medicine. 5th ed. Philadelphia: Mosby Elsevier; 2007. p. 125–60.

    Chapter  Google Scholar 

  4. Mant AK. Some post-mortem observations in accidental observations. Med Sci Law. 1964;4:44–6.

    PubMed  CAS  Google Scholar 

  5. Mant AK. Autopsy diagnosis of accidental hypothermia. J Forensic Med. 1969;16:126–9.

    PubMed  CAS  Google Scholar 

  6. Lim C, Duflou J. Hypothermia fatalities in a temperate climate: Sydney, Australia. Pathology. 2008;40:46–51.

    Article  PubMed  Google Scholar 

  7. Niazi SA, Lewis FJ. Profound hypothermia in man: report of a case. Ann Surg. 1958;147:264–6.

    Article  PubMed  CAS  Google Scholar 

  8. Gilbert M, Busund R, Skagseth A. Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest. Lancet. 2000;355:375.

    Article  PubMed  CAS  Google Scholar 

  9. Keatinge WR. Death after shipwreck. Br Med J. 1965;25:1537–41.

    Article  Google Scholar 

  10. Epstein E, Anna K. Accidental hypothermia. BMJ Learn. 2006;332:706–9.

    Article  Google Scholar 

  11. Anderson TW, Le Riche WH. Cold weather and myocardial infarction. Lancet. 1970;i:291–6.

    Article  Google Scholar 

  12. Wilmhurst P. Temperature and cardiovascular mortality. BMJ. 1994;309:1029.

    Article  Google Scholar 

  13. Jeremitsky E, Omert L, Dunham C, et al. Harbingers of poor outcome the day after severe brain injury: hypothermia, hypoxia, and hypoperfusion. J Trauma. 2003;54:312–9.

    Article  PubMed  Google Scholar 

  14. Clifton GL, Miller ER, Sung CC, et al. Lack of effect of induction of hypothermia after acute brain injury. N Engl J Med. 2001;344:556–63.

    Article  PubMed  CAS  Google Scholar 

  15. Shafi S, Elliott AC, Gentilello L. Is hypothermia simply a marker of shock and injury severity or an independent risk factor for mortality in trauma patients? Analysis of a large national trauma registry. J Trauma. 2005;59:1081–5.

    Article  PubMed  Google Scholar 

  16. Schwaninger M, Weisbrod M, Schwab S, et al. Hypothermia induced by atypical neuroleptics. Clin Neuropharmacol. 1998;21:344–6.

    PubMed  CAS  Google Scholar 

  17. Young DM. Risk factors for hypothermia in psychiatric patients. Ann Clin Psychiatry. 1996;8:93–7.

    Article  PubMed  CAS  Google Scholar 

  18. Blass DM, Chuen M. Olanzapine-associated hypothermia. Psychosomatics. 2004;45:125–39.

    Article  Google Scholar 

  19. Wedin B, Vanggaard L, Hirvonen J. “Paradoxical undressing” in fatal hypothermia. J Forensic Sci. 1979;24:543–53.

    PubMed  CAS  Google Scholar 

  20. Sivaloganathan S. Paradoxical undressing due to hypothermia in a child. Med Sci Law. 1985;25:176–8.

    PubMed  CAS  Google Scholar 

  21. Osamu S, Keiko S, Hiroshi S et al. Diagnosis of fatal hypothermia – incidence of specific medico - legal findings in fatal hypothermia cases. Acta Criminologiae et Medicinae Legalis Japonica 2002; 68:56–60.

    Google Scholar 

  22. Sauuko P, Knight B. Neglect, starvation and hypothermia. In: Knight’s forensic pathology. 3rd ed. London: Arnold; 2004. p. 418–9.

    Google Scholar 

  23. Rothschild MA, Schneider V. Terminal burrowing behaviour – a phenomenon of lethal hypothermia. Int J Legal Med. 1995;107:250–6.

    Article  PubMed  CAS  Google Scholar 

  24. Hirvonen J. Necropsy findings in fatal hypothermia cases. Forensic Sci. 1976;8:155–64.

    Article  PubMed  CAS  Google Scholar 

  25. Türk EE, Sperhake JP, Madea B, et al. Immunohistochemical detection of hemoglobin in frost erythema. Forensic Sci Int. 2006;158:131–4.

    Article  PubMed  Google Scholar 

  26. Turk EE. Hypothermia. Am J Forensic Med Pathol. 2010;6:106–15.

    Article  Google Scholar 

  27. Tsokos M, Rothschild M, Madea B, et al. Histological and immunohistochemical study of Wischnevsky spots in fatal hypothermia. Am J Forensic Med Pathol. 2006;27:70–4.

    Article  PubMed  Google Scholar 

  28. Preuss J, Dettmeyer R, Lignitz E, Madea B. Fatty degeneration of myocardial cells as a sign of death due to hypothermia versus degenerative deposition of lipofuscin. Forensic Sci Int. 2006;159:1–5.

    Article  PubMed  CAS  Google Scholar 

  29. Preuss J, Lignitz E, Dettmeyer R, Madea B. Pancreatic changes in cases of death due to hypothermia. Forensic Sci Int. 2007;166:194–8.

    Article  PubMed  CAS  Google Scholar 

  30. Preuss J, Dettmeyer R, Lignitz E, et al. Fatty degeneration in renal tubule epithelium in accidental hypothermia victims. Forensic Sci Int. 2004;141:131–5.

    Article  PubMed  CAS  Google Scholar 

  31. Doberentz E, Preuss-Wössner J, Kuchelmeister K, Madea B. Histological examination of the pituitary glands in cases of fatal hypothermia. Forensic Sci Int. 2011;207:46–9.

    Article  PubMed  CAS  Google Scholar 

  32. Hejna P, Zátopková L, Tsokos M. The diagnostic value of synovial membrane hemorrhage and bloody discoloration of synovial fluid (“inner knee sign”) in autopsy cases of fatal hypothermia. Int J Legal Med. 2012;126(3):415–9.

    Article  PubMed  CAS  Google Scholar 

  33. Hirvonen J, Huttunen P. Increased urinary concentration of catecholamines in hypothermia deaths. J Forensic Sci. 1982;27:264–71.

    PubMed  CAS  Google Scholar 

  34. Sadler DW, Pounder DJ. Urinary catecholamines as markers of hypothermia. Forensic Sci Int. 1995;76:227–9.

    Article  PubMed  CAS  Google Scholar 

  35. Tipton M. Thermal stress and survival. In: Rainford D, Gradwell DP, editors. Ernsting’s aviation medicine. 4th ed. London: Hodder Arnold; 2006. p. 213–29.

    Chapter  Google Scholar 

  36. Ward M. Frostbite. BMJ. 1974;1:67–70.

    Article  PubMed  CAS  Google Scholar 

  37. Travis S, Roberts D. Arctic Willy. BMJ. 1989;299:1573–4.

    Article  PubMed  CAS  Google Scholar 

  38. Schäfer AT, Kaufmann JD. What happens in freezing bodies? Experimental study of histological tissue change caused by freezing injuries. Forensic Sci Int. 1999;102:149–58.

    Article  PubMed  Google Scholar 

  39. Bouchama A, Knochel JP. Heat stroke. N Engl J Med. 2002;346:1978–88.

    Article  PubMed  CAS  Google Scholar 

  40. Armen R, Kanel G, Reynolds T. Phencyclidine-induced malignant hyperthermia causing submassive liver necrosis. Am J Med. 1984;77:167–72.

    Article  PubMed  CAS  Google Scholar 

  41. Wetli CV, Mash D, Karch SB. Cocaine-associated agitated delirium and the neuroleptic malignant syndrome. Am J Emerg Med. 1996;14:425–8.

    Article  PubMed  CAS  Google Scholar 

  42. Milroy CM, Clark JC, Forrest AR, Milroy CM, Clark JC, Forrest AR. Pathology of deaths associated with “ecstasy” and “eve” misuse. J Clin Pathol. 1996;49:149–53.

    Article  PubMed  CAS  Google Scholar 

  43. Malmud N, Haymaker W, Custer P. Heat stroke. A clinicopathologic study of 125 fatal cases. Mil Surg. 1946;99:397–449.

    Google Scholar 

  44. Gore I, Isaacson NH. The pathology of hyperpyrexia. Observations at autopsy in 17 cases of fever therapy. Am J Pathol. 1949;25:1029–105.

    PubMed  CAS  Google Scholar 

  45. Kew MC, Tucker RBK, Bersohn I, Seftel HC. The heart in heatstroke. Am Heart J. 1969;77:324.

    Article  PubMed  CAS  Google Scholar 

  46. Kew M, Bersohn I, Seftel H, Kent G. Liver damage in heatstroke. Am J Med. 1970;49:192–202.

    Article  PubMed  CAS  Google Scholar 

  47. Bianchi L, Ohnacker H, Beck K, Zimmerli-Ning M. Liver damage in heatstroke and its regression. A biopsy study. Hum Pathol. 1972;3:237–48.

    Article  PubMed  CAS  Google Scholar 

  48. Chao TC, Sinniah R, Pakiam JE. Acute heat stroke deaths. Pathology. 1981;13:145–56.

    Article  PubMed  CAS  Google Scholar 

  49. Rubel LR, Ishak KG. The liver in fatal exhertional heatstroke. Liver. 1983;3:249–60.

    PubMed  CAS  Google Scholar 

  50. Meilke AW, Graybill JR. Fibrinolysis and haemorrhage in heatstroke. N Engl J Med. 1967;276:911–3.

    Article  Google Scholar 

  51. Weber MB, Blakely JA. The haemorrhagic diathesis of heatstroke. Lancet. 1969;i:1190–2.

    Article  Google Scholar 

  52. Haresh M, McDonald G, Hood IC, et al. Heat-related deaths in Philadelphia – 1993. Am J Forensic Med Pathol. 1996;17:106–8.

    Article  Google Scholar 

  53. Kaiser R, Rubin CH, Henderson AK, et al. Heat-related death and mental illness during the 1999 Cincinnati heat wave. Am J Forensic Med Pathol. 2001;22:303–7.

    Article  PubMed  CAS  Google Scholar 

  54. Keatinge W. Death in heat waves. BMJ. 2003;327:512.

    Article  PubMed  Google Scholar 

  55. Baccini M, Kosatsky T, Analitis A, et al. Impact of heat on mortality in 15 European cities: attributable deaths under different weather scenarios. J Epidemiol Community Health. 2011;65:64–70.

    Article  PubMed  CAS  Google Scholar 

  56. Whitman S, Good G, Donoghue E. Mortality in Chicago attributed to the July 1995 heat wave. Am J Public Health. 1997;87:1515–8.

    Article  PubMed  CAS  Google Scholar 

  57. Shen T, Howe HL, Alo C, et al. Toward a broader definition of heat related death: comparison of mortality estimates from medical examiners’ classification with those from total death differentials during the July 1995 heat wave in Chicago. Am J Forensic Med Pathol. 1998;19:113–8.

    Article  PubMed  CAS  Google Scholar 

  58. Semenza JC, Rubin CH, Falter KH, et al. Heat-related deaths during the July 1995 heat wave in Chicago. N Engl J Med. 1996;335:84–90.

    Article  PubMed  CAS  Google Scholar 

  59. Dematte JE, O’Mara K, Buescher J, et al. Near-fatal heat stroke during the 1995 heat wave in Chicago. Ann Intern Med. 1998;129:173–81.

    Article  PubMed  CAS  Google Scholar 

  60. Davido A, Patzak A, Dart T, et al. Risk factors for heat related death during the August 2003 heat wave in Paris, France, in patients evaluated at the emergency department of the Hôpital Européen Georges Pompidou. Emerg Med J. 2006;23:515–8.

    Article  PubMed  CAS  Google Scholar 

  61. Martin-Latry K, Goumay M-P, Latry P, et al. Psychotropic drugs use and risk of heat-related hospitalization. Eur Psychiatry. 2007;22:335–8.

    Article  PubMed  Google Scholar 

  62. Nordon C, Martin-Latry K, de Roquefeuil L, et al. Risk of death related to psychotropic drug use in older people during the European 2003 heatwave: a population-based case-control study. Am J Geriatr Psychiatry. 2009;17:1059–67.

    Article  PubMed  Google Scholar 

  63. Donoghue ER, Graham MA, Jentzen JM. Criteria for the diagnosis of heat-related deaths: National Association of Medical Examiners. Position paper. National Association of Medical Examiners Ad Hoc Committee on the Definition of Heat-Related Fatalities. Am J Forensic Med Pathol. 1997;18:11–4.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Anatomical Pathology, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada

    Christopher M. Milroy MBCHB MD LLB FRCPath FRCPC DMJ & Jacqueline L. Parai B.Sc., M.D., M.Sc., FRCPC

  2. Department of Pathology and Laboratory Medicine, The Ottawa Hospital, The University of Ottawa, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada

    Christopher M. Milroy MBCHB MD LLB FRCPath FRCPC DMJ & Jacqueline L. Parai B.Sc., M.D., M.Sc., FRCPC

  3. Eastern Ontario Forensic Pathology Unit, Ontario Forensic Pathology Service, Ottawa, ON, Canada

    Christopher M. Milroy MBCHB MD LLB FRCPath FRCPC DMJ & Jacqueline L. Parai B.Sc., M.D., M.Sc., FRCPC

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  1. Christopher M. Milroy MBCHB MD LLB FRCPath FRCPC DMJ
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  2. Jacqueline L. Parai B.Sc., M.D., M.Sc., FRCPC
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Correspondence to Christopher M. Milroy MBCHB MD LLB FRCPath FRCPC DMJ .

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Editors and Affiliations

  1. , Forensic Pathology Unit, Leicester Royal Infirmary, Robert Kilpatrick Clinical Sciences Building, Leicester, LE2 7LX, United Kingdom

    Guy N. Rutty

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Milroy, C.M., Parai, J.L. (2013). Deaths from Extremes of Temperature. In: Rutty, G. (eds) Essentials of Autopsy Practice. Springer, London. https://doi.org/10.1007/978-0-85729-519-4_2

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  • DOI: https://doi.org/10.1007/978-0-85729-519-4_2

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