Cyanide, a mitochondrial toxin, is considered one of the most lethal substances to which humans may be exposed. There are several cyanide compounds, the most common being sodium or potassium salts, hydrogen cyanide gas, and cyanogenic glycosides found in plants. Most poisonings occur through oral ingestion, representing a major diagnostic challenge both in medical care settings and in the forensic investigation of deaths. The handling of bodies of individuals who died from cyanide poisoning presents an occupational risk due to potential exposure to gases released from the body. Considering the scarcity of national data on this subject, a study was conducted using 13 autopsy reports of oral cyanide poisoning from the Toxicology Laboratory of the André Roquette Medical Examiner’s Office, covering the period from 2002 to 2018. In seven cases, suicide was suspected, while the remaining cases were classified as deaths of undetermined circumstances. Most victims were male (84.6%), White (76.9%), and the mean age was 41.8 years. Four individuals received medical care prior to death. Regarding external findings, three individuals presented mucocutaneous cyanosis. The characteristic bitter almond odor and reddish coloration of the skin or postmortem lividity were not described in any case. Internal examination revealed that the most prevalent findings were foamy secretions within the lungs and visceral petechiae. Gastric alterations were observed in three individuals. Blood alcohol concentration was investigated in most cases, with positive results in two individuals. These data contribute to a better epidemiological characterization of fatal oral cyanide poisoning cases and may improve the understanding of such occurrences.
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