A detailed autopsy report released Monday found Anna Nicole Smith endured stomach flu, a 100-degree fever, pungent sweating and an infection on her buttocks from repeated injections for several days before accidentally overdosing on a least nine prescription drugs, including a strong sleep syrup she was drinking straight from a bottle.

Broward County Medical Examiner Dr. Joshua Perper noted the former Playboy playmate refused to go to a hospital three days before her Feb. 8 death. She chose to endure her illness in a hotel suite littered with pill bottles, soda cans, SlimFast, nicotine gum and an open box of Tamiflu tablets.

Perper also found in the days leading up to her death, Smith, 39, had been taking large amounts of the seldom prescribed sedative chloral hydrate, which contributed to the 1962 overdose death of Smith's idol, Marilyn Monroe.

Police found no apparent signs of foul play. The medical examiner also ruled Smith's death probably was not a suicide. He said people who take their own lives usually use much more lethal drugs than chloral hydrate.

Perper said Smith might not have been aware the sedative could be fatal in combination with multiple other prescriptions she was taking in normal doses for anxiety, depression and insomnia.

Contributing factors included her weakened condition from a stomach flu and fever brought on by a pus-filled infection on her buttocks from repeated injections of longevity medications, vitamin B-12 and a growth hormone.

"She may have taken the dosages she was accustomed to but succumbed because she was already weakened," Perper said in his report. "Miss Smith has a long history of prescription drug abuse and self-medicated in the past."

The prescribed dose of chloral hydrate is one to two teaspoons before bed. Smith often took two tablespoons, and she sometimes drank directly from the bottle, the report said.

A statement issued by lawyers for Howard K. Stern, Smith's companion, who was with her before her death, said Smith's physician and Stern urged her to get emergency treatment but she refused because "she did not want the media frenzy that follows her."

"Anna called the shots in Anna's life, and everyone close to her knows that," said attorney Lilly Ann Sanchez in a statement.

Perper said Smith could have been saved had she been hospitalized earlier in the week, simply because her drug intake could have been controlled.

"If she would have gone to the hospital she wouldn't have died, because she wouldn't have had the opportunity to take the excessive amount of chloral hydrate," he told The Associated Press.

Editor: Donald