Case report--death by subcutaneous injection of cyanide in Sri Lanka.

An elderly man was stabbed with a needle and syringe onto his abdomen while asleep. He progressively developed respiratory failure and coma and died an hour later. Autopsy findings and laboratory analysis confirmed the death as being due to poisoning by cyanide. This case highlights the need to consider cyanide as a possible agent where there is a rapid death with progressive respiratory failure after injection of an unknown substance. Cyanide poisoning by ingestion is frequently seen in suicidal, accidental and homicidal deaths. To our knowledge, this is the first reported case of cyanide poisoning by injection in Sri Lanka.