[Death due to hypothermia and paradoxical undressing]

Hypothermia is a rare cause of death in Israel, and usually occurs among risk groups such as elderly people, homeless persons, psychiatric patients and persons who function in cold environments or are unintentionally exposed to such conditions. Death due to hypothermia generally occurs in extremely cold conditions, although ambient temperatures of 15-20 degrees C can also be lethal. The phenomenon of paradoxical undressing that characterizes death due to hypothermia rather occurs in moderate ambient temperatures, and takes place when the victim is in extremis. A case of death of an elderly man, whose body was found naked in a field, is reported. His head was covered with a shirt, and blunt injuries were found on his body, raising suspicion that he was smothered, or was a victim of sexual violence. On autopsy, spot hemorrhages of the gastric mucosa, which are characteristic of hypothermia, were found, along with mild cerebral atrophy, moderate atherosclerosis of the coronary and cerebral vessels and myocardial sclerosis. The combination of autopsy findings, elimination of traumatic injuries as contributors to death and the circumstances in which the body was found, led to the diagnosis of death due to hypothermia.