Forensic investigations in foodborne deaths by microorganisms

Fatal foodborne infections and intoxications represent a relatively rare but highly complex category of deaths in forensic practice. Their medico-legal relevance lies in the difficulty of establishing a clear causal relationship between food consumption, pathogen exposure, and death, owing to nonspecific clinical presentations, limited macroscopic findings, and post-mortem confounding factors.

This mini-review aims to provide a practical and multidisciplinary framework for the forensic investigation of deaths due to microbial foodborne poisoning, integrating circumstantial data, autopsy findings, histopathology, post-mortem microbiology, molecular epidemiology, and toxicology.

A literature search was conducted up to January 2026 using PubMed, Scopus and Google Scholar, focusing on fatal foodborne infections and intoxications in forensic contexts. English-language publications addressing autopsy findings, post-mortem microbiology, molecular techniques, and medico-legal implications were included.

Fatal outcomes are most commonly associated with dehydration, electrolyte imbalance, hypovolemic shock, sepsis, multiorgan failure, or disseminated intravascular coagulation. Autopsy findings and histopathological features are often nonspecific and require careful interpretation. Post-mortem microbiology, when performed under sterile conditions and within appropriate time frames, combined with molecular typing techniques, significantly improves diagnostic accuracy and supports causal attribution.

Determining death due to microbial foodborne poisoning requires a holistic forensic approach in which circumstantial and genealogical evidence, pathological findings, microbiological data, and toxicological analyses are integrated. Furthermore, advances in molecular epidemiology have strengthened the ability to establish causality and trace sources of contamination, reinforcing the role of forensic medicine both in the resolution of individual cases and in the broader protection of public health.