Envenomations by toxic creatures is a global health problem with an annual mortality from snake envenomation of over 125,000 cases. While various snake species bites are the most commonly encountered fatal envenomation, scorpions, spiders and marine creatures can all cause fatalities. Although venomous creatures have specific geographical habitats, the keeping of exotic pets and modern transportation, along with venomous collections in zoos, means that fatal envenomations may be encountered in non-endemic areas. There are a variety of toxins that may be encountered including neurotoxins, proteases, and myotoxins that will result in a variable amount of tissue damage depending upon the species involved and the toxin they carry. The autopsy findings may be relatively nonspecific and a careful search of the skin may be required to identify the envenomation site, along with a consideration of the history and the scene. External and internal damage will vary with the specific toxin. This paper reviews fatal envenomations, the toxinology and likely autopsy findings.
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