• Andreea Alexandra HLESCU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Adriana GRIGORAS “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • C.S. HLESCU “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Cornelia AMALINEI “Grigore T. Popa” University of Medicine and Pharmacy Iasi


Accidental hypothermia fatalities are the result of extreme external environmental temperature exposure. These are an area of interest for research due to their complex features of diagnosis of certainty and the mechanisms involved in thanatogenesis. Our study aims to evaluate the macroscopic features associated with cold stress in a large group of accidental hypothermia fatalities. Materials and methods: The study comprised a retrospective analysis of 107 accidental hypothermia fatalities, diagnosed between 2007 and 2021, in the Forensic Medicine Institute Iași. Results: Variable reddish to purplish color cadaveric lividity, scrotum retraction (60% of males), intense red blood color (60.7% of cases), and skin lesions secondary to cold exposure, such as cold erythema or acute pernio (49.05% of cases), frostbites (49.7% of cases), and immersion foot (12.1% of cases) were the main macroscopic findings registered during autopsy. In addition, fetal position of the body and paradoxical undressing were other autopsy gross features identified in 12.1% and 9.3% of cases, respectively. The gross exam of the internal organs revealed Wischnewski spots (44.8%), pulmonary subpleural petechiae (11%), and Puharevici’s sign (53.3%). Statistical analysis revealed a significant correlation between frostbites degree and temperature at hospitalization, between Wischnewski spots and core temperature, or alcoholaemia and traumatic injuries. Conclusions: Although the macroscopic features related to accidental hypothermia death are often non-specific, inconstant or even negative, their interpretation in the context of forensic investigation data, such as cold exposure evidence, social conditions, and histopathological data may contribute to hypothermia death diagnosis.

Author Biographies

Andreea Alexandra HLESCU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine,
Department of Medical Specialties (III)
Institute of Legal Medicine, Iași, Romania

Adriana GRIGORAS, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Morpho-functional Sciences (I)
Institute of Legal Medicine, Iași, Romania

C.S. HLESCU, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine,
Department of Surgery (I)

Cornelia AMALINEI, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine,
Department of Morpho-functional Sciences (I)
Institute of Legal Medicine, Iași, Romania


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