Suspected poisoning associated with an unidentified traditional preparation in an infant: an autopsy case report from Kindia, Guinea

Background: Poisoning in infants following the administration of unidentified traditional preparations may raise major diagnostic and forensic challenges, particularly when toxicological testing is unavailable. Case presentation: We report the case of a 10-month-old girl who was reportedly given an unidentified liquid preparation by mouth by a traditional healer in Kindia, Guinea, on 2 February 2025. Unusual cries, persistent crying and blood-stained oral secretions developed within minutes. The child was admitted to Kindia Regional Hospital and subsequently transferred to Donka University Hospital in Conakry because of clinical deterioration. She died on 8 February 2025. The autopsy, performed on 9 February 2025, revealed ulceronecrotic lesions involving the lips, perioral region, tongue, pharynx, larynx, trachea, main bronchi, oesophagus and stomach, together with marked pulmonary oedema and diffuse congestion. Histopathological examination showed acute inflammation with tissue necrosis. Toxicological testing was not performed because it was unavailable locally. Conclusion: The clinical chronology and post-mortem findings raise suspicion of severe injury following exposure to an unidentified substance. However, in the absence of toxicological testing, the substance involved and its specific contribution to death could not be established conclusively. This case highlights the diagnostic limitations encountered in suspected poisoning when toxicological investigations are unavailable.