Korean J Leg Med.  2020 May;44(2):96-101. 10.7580/kjlm.2020.44.2.96.

Death by Nitrite Intoxication: Report of 14 Cases

  • 1Division of Forensic Medicine, National Forensic Service Seoul Institute, Seoul, Korea
  • 2Department of Medicine, Seoul National University College of Medicine, Seoul, Korea


Sodium nitrite intoxication is a primary cause of severe methemoglobinemia, which may be fatal. In the past, nitrite-related deaths were rare, but cases of suicide with nitrite have been increasing in number in recent years. We analyzed 14 cases of fatal nitrite intoxication from January 2013 to February 2019. There was a different trend between the cases from the past and those from recent years. The former consisted of older individuals who ingested nitrite accidentally or intentionally, while the latter comprised younger individuals who used nitrite mostly for suicide. Most individuals showed dark purple or dark brown lividity and cherry-pink discoloration of the muscles. Postmortem methemoglobin levels, which were analyzed in 5 cases, were 30%-49%. Most nitrite and nitrate concentrations showed the highest concentration in the stomach contents, and it showed that the nitrite was converted into nitrate in the blood. To conclude, methemoglobin tests using a portable oximeter and quantitative tests of nitrite and nitrate, as well as a thorough investigation of the case and scene may help determine the cause of death.


Methemoglobinemia; Sodium nitrite; Poisoning; Autopsy
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