A woman is found dead in a locked room during winter with all windows closed. The postmortem lividity appears cherry-pink instead of the usual bluish-purple colour. The most probable cause of death is:

• A Drowning
• B Carbon monoxide poisoning
• C Cyanide poisoning
• D Both B and C are equally likely causes ✓

Explanation

Cherry-pink or bright-red postmortem lividity is classically seen in both carbon monoxide poisoning (formation of carboxyhaemoglobin) and cyanide poisoning (cells cannot utilise oxygen, leaving oxyhaemoglobin in venous blood). In a closed winter room with possible heating equipment, CO from incomplete combustion is highly plausible, but cyanide poisoning also produces the same colour. Other causes include hydrogen cyanide, cold exposure deaths, and refrigerated bodies. Both B and C must be considered pending toxicological analysis.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.