{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T04:00:17Z","timestamp":1784433617773,"version":"3.55.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2013,7,3]],"date-time":"2013-07-03T00:00:00Z","timestamp":1372809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Forensic Sciences"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Acetaminophen or paracetamol, a commonly used over\u2010the\u2010counter analgesic, is known to elicit severe adverse reactions when taken in overdose, chronically at therapeutic dosage or, sporadically, following single assumptions of a therapeutic dose. Damage patterns including liver damage and, rarely, acute tubular necrosis or a fixed drug exanthema. We present a case of fatal acetaminophen toxicity with postmortem blood concentration 78\u00a0\u03bcg\/mL and unusual clinical features, including a visually striking and massive epidermolysis and rhabdomyolysis, disseminated intravascular coagulation and myocardial ischemia. This case is compared with the most similar previous reports in terms of organ damage, clinical presentation, and cause of death. We conclude that a number of severe patterns of adverse effects to acetaminophen are emerging that were previously greatly underestimated, thus questioning the adequacy of the clinical spectrum traditionally associated with acetaminophen intoxication and leading to the need to review this spectrum and the associated diagnostic criteria.<\/jats:p>","DOI":"10.1111\/1556-4029.12205","type":"journal-article","created":{"date-parts":[[2013,7,4]],"date-time":"2013-07-04T06:24:09Z","timestamp":1372919049000},"page":"1397-1400","source":"Crossref","is-referenced-by-count":9,"title":["Possible Fatal Acetaminophen Intoxication with Atypical Clinical Presentation"],"prefix":"10.1111","volume":"58","author":[{"given":"Fabio","family":"De\u2010Giorgio","sequence":"first","affiliation":[{"name":"Institute of Legal Medicine Catholic University School of Medicine L.go F. Vito 1 00168 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lodise","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine Catholic University School of Medicine L.go F. Vito 1 00168 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Chiarotti","sequence":"additional","affiliation":[{"name":"Institute of Legal Medicine Catholic University School of Medicine L.go F. Vito 1 00168 Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"d'Aloja","sequence":"additional","affiliation":[{"name":"Department of Public Health Forensic Medicine Section Cagliari University Km 4.500 SS. 554 Bivio per Sestu 09042 Monserrato Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaldo","family":"Carbone","sequence":"additional","affiliation":[{"name":"Institute of Pathologic Anatomy School of Medicine Catholic University L.go F. 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