Abstract
We describe the fatal course of a patient with initial symptoms of vomiting and nausea who developed symptoms of dystonia, encephalopathy, and coma. The cause of death was poisoning with 3-nitropropionic acid from coconut water spoiled with the fungus
Arthrinium saccharicola. We present the clinical findings and forensic analysis.
A 69-year old Caucasian man was admitted to Aarhus University Hospital, Aarhus, Denmark, in a state of reduced consciousness and Glasgow Coma Scale (GCS) score of 13–14. Approximately 4.5 hours before admission, the patient had consumed coconut water directly from a coconut using a straw. Because the water had a foul taste, he swallowed only a small amount. Afterward, he opened the nut and described to his wife that the interior was slimy and looked rotten.