Abstract

Forensic medicine frequently addresses deaths that are sudden, unexpected, or legally significant, with a substantial proportion attributable to clinically significant natural diseases. These include cardiovascular, neurological, endocrine, and infectious conditions, which can pose diagnostic challenges in differentiating natural from unnatural causes of death. Sudden cardiac death (SCD), often the most common natural cause, requires careful assessment to rule out external triggers and to identify underlying heritable disorders through postmortem genetic testing. Neurological conditions such as epilepsy, particularly sudden unexpected death in epilepsy (SUDEP), and acute metabolic derangements including diabetic ketoacidosis or adrenal crisis, demand targeted pathological and biochemical evaluation. Infectious diseases ranging from fulminant bacterial infections to emerging viral pathogens like SARS-CoV-2 carry both medicolegal and public health implications, with the forensic pathologist serving as a sentinel for disease surveillance. The interplay between clinical pathophysiology, forensic investigation, and public health response underscores the need for a multidisciplinary approach. This narrative review synthesizes current knowledge on the forensic relevance of diseases spanning from SCD to infectious outbreaks, highlighting investigative strategies, diagnostic challenges, and preventive opportunities.

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