Initial difficulty in understanding his speech progressed to severe laryngeal and glossal edema over a 3.5- hour period. His airway became obstructed less than a minute after arrival at the emergency room. Oral intubation was unsuccessful, and a difficult tracheostomy was too late to save the patient. The death was reported to the medical examiner because of its sudden and unusual nature, and an autopsy was performed. Based on autopsy findings, it was determined that medical examiners should be sensitive to the possibility of angiotensin-converting enzyme inhibitor therapy causing obstructive angioedema in cases that may otherwise appear to be typical bee or wasp sting reactions. 8 references