Filigree burns of a lightning strike: A case series

Lightning is the discharge of an electric charge forming in the atmosphere between the earth and clouds which travels downward in a branching pattern. It is estimated that there are some 1800 active thunderstorms at any given moment. Lightning may injure or kill a person by a direct strike, a side-flash or conduction through another object. Agricultural workers are at risk in developing and underdeveloped countries, as are those engaging in sporting activities elsewhere. Fatalities resulting from lightning strikes may not show specific symptoms at autopsy, but there may be symptoms of burns on clothes and body and fernlike marks specific to lightning strikes on their bodies. Other signs are acute kidney failure, cardiac arrhythmias and deaths, and while internal organs may show oedema, congestion, etc, this is not in itself sufficient to establish causation. When diagnosing death from a lightning strike, it is essential to examine the deceased's clothes, their external body and carry out a crime scene investigation. We report a series of three cases of death from a lightning strike in previously healthy men engaged in their daily activities.