Wischnewski spots and ethylene glycol fatal poisoning: a case report

We present the case of a woman who was found dead in a countryside 11 days after disappearing from home. At the examination of the scene of death a black plastic can of antifreeze fluid was found near the body. The autopsy and complementary analysis allowed us to establish that the cause of death was an irreversible cardio-circulatory arrest caused by acute poisoning by the ingestion of ethylene glycol. Moreover, the gastric mucosa showed numerous black hemorrhagic spots, histologically diagnosed to be “Wischnewski spots”. Therefore, because most of the toxicity of ethylene glycol comes from its acid metabolites, we suggest that the presence of WSs in this case is strictly related to metabolic acidosis, supporting the thesis that acidosis plays a crucial role in the pathogenesis of WSs. This is the first paper, to the best of our knowledge, that shows a correlation between ethylene glycol poisoning and Wischnewski spots.