Georgi Markov - death in a pellet

Abstract

A male refugee had been struck by a small pellet in the back of his right thigh and developed alarming morbid symptoms: local swelling, regional lymphadenopathy, fever, hypotension, collapse, anuria and total heart block. He died four days after the event. At autopsy interstitial hemorrhages were remarkable; there was fatty toxic change of the liver and hemorrhagic necrosis of the small intestine as well as hemorrhagic disruption of lymphglands in the right groin. The pellet removed at autopsy proved to be of very hard steel and had drilled holes at right angles to one another. The autopsy conclusion was: toxemia due to the pellet. Despite extensive and intensive research, a toxic substance (chemical and/or bacterial) could not be found. The clinicopathologic picture resembled the toxic action of ricin.