Was a child poisoned by ethanol? Discrimination between ante-mortem consumption and post-mortem formation

Abstract

The presence of ethanol in human specimens collected during autopsies is generally considered as an indication of recent ante-mortem alcohol consumption. The interpretation of the results may however be impaired by post-mortem formation of ethanol when microorganisms capable of fermentation of glucose to ethanol are present. Since the distribution in the different fluids and tissues remains contentious to conclude on the origin of the detected ethanol, the determination of specific metabolites of ethanol such as ethyl glucuronide (EtG) may be performed to discriminate between exogenous (ante-mortem) and endogenous (post-mortem). Toxicological analysis of specimens from the autopsy of a child aged 14 months displayed a high concentration of ethanol in blood and tissues. In order to discriminate between ante-mortem alcohol administration and post-mortem formation, the presence of microorganisms capable of ethanol production was checked by fermentation tests and the liver was tested for the presence of EtG and compared with a positive control. Fermentation tests displayed in the blood of the deceased the presence of the bacterial strain Lactococcus garvieae capable of producing ethanol from glucose. The absence of EtG in the liver of the deceased compared to the high level (19.56 mug/g) detected in the positive control's liver is a further indication that the ethanol detected in the body of the deceased is of post-mortem origin.

The Relationship Between Alcohol Consumption and Fatal Motor Vehicle Injury: High Risk at Low Alcohol Levels

“…The time between injury occurring and the forensic pathological investigation may be anywhere from 1 to 12 hours and time-dependent ethanol (EtOH) degradation has been reported in the forensic pathology literature (Ferrari et al, 2006;Halter et al, 2009), resulting in possible underestimation of the BAC. The overestimation of BAC may also be possible, although unlikely, because of a buildup of EtOH-producing bacteria that may occur after death (Appenzeller et al, 2008;Collison, 2005). In recent years (since the mid-1990s), this problem has largely been resolved via the testing of other bodily fluids, such as vitreous humor, where EtOH levels have been shown to be very stable over time (Chao and Lo, 1993).…”

False‐Positive Meconium Test Results for Fatty Acid Ethyl Esters Secondary to Delayed Sample Collection

“…Of interest, risk of false‐positive EtOH results because of microbial fermentation is a well‐known complication of EtOH analysis in forensic cases (O'Neal and Poklis, ). Numerous studies have demonstrated that significant amounts of EtOH can be produced in human corpses and in isolated tissues contaminated by microorganisms (Appenzeller et al., ; Collison, ; Helander et al., ; Kuhlman et al., ; Lewis et al., ). Intestinal microorganisms play an important role in postmortem EtOH production as they penetrate the intestinal walls and distribute to blood and tissues after death (Boumba et al., ).…”

Assessment of the stability of the ethanol metabolite ethyl sulfate in standardised degradation tests

“…As a consequence, EtG and EtS could then be used as markers for differentiation of ante mortem ethanol consumption or post-mortem generation of ethanol [14,15]. However, the absence of EtG can result from bacterial degradation (as well as its presence might be a result from bacterial formation from ethanol) -while until now, EtS was described as stable against bacterial degradation [12,13,16] -and therefore -if detected -would be useful in those cases, to prove alcohol consumption prior to death.…”