@article{ref1,
title="Fatal intoxication due to tramadol alone: case report and review of the literature",
journal="Forensic science international",
year="2008",
author="De Decker, Koen and Cordonnier, Jan A. C. M. and Jacobs, Werner and Coucke, V. and Schepens, P. and Jorens, P. G.",
volume="175",
number="1",
pages="79-82",
abstract="Poisoning may also lead to both coma and multiple organ failure, also in youngsters without a known major medical history. As not all toxic agents are routinely screened when a poisoning is suspected, it is useful to consider less frequently encountered poisons in certain cases. We describe the occurrence of asystole and multiple organ failure which occurred in a young man after a suspected tramadol overdose. The tramadol concentration on admission in the ICU was indeed 8 microg/ml (mg/l), far above the therapeutic range. Subsequently, the patient developed severe acute liver failure, finally leading to death. Post-mortem toxicology did not reveal any other poison responsible for this unfavourable course as only very high serum and tissue tramadol and desmethyltramadol concentrations were found. Only a few fatal poisonings attributable to tramadol alone, as observed in our case, have been reported. An overview of these cases is presented.<p /><p>Language: en</p>",
language="en",
issn="0379-0738",
doi="10.1016/j.forsciint.2007.07.010",
url="http://dx.doi.org/10.1016/j.forsciint.2007.07.010"
}