ABSTRACT
The effective value of microbiological post-mortem examinations stands as fundamental in forensic cases involving microbiology. We ran these analyses on five victims, who suddenly died after showing persistent fever. The examinations were conducted between 48 hours and 10 days after death, and adrenal gland apoplexy was detected in all the cases. Microbiological examinations identified Neisseria meningitidis, which was accountable for WaterhouseFriderichsen syndrome. Diplococci were isolated from three cadavers that underwent forensic dissection between 2 and 3 days after death. The remaining two cadavers showed polymicrobial contamination, and a polymerase chain reaction technique was necessary to identify the pathogen. We assumed that the microbial overlap could lead to diagnostic mistakes and conceal the identification of the lethal pathogen. Therefore, we suggest using molecular techniques for a postmortem interval (PMI) longer than 72 hours. Classical microbiological examination should be performed for PMI within 72 hours.
Subject(s)
Humans , Autopsy/methods , Waterhouse-Friderichsen Syndrome/pathology , Microbiological Techniques , Fatal Outcome , Neisseria meningitidisABSTRACT
É apresentado o caso de uma paciente adulta jovem, previamente sadia, que, em 24 horas, desenvolveu febre com mialgias e artralgias, intensa agitaçäo psicomotora e queda do nível de consciência, simultaneamente com o aparecimento de lesöes petioquiais, lesöes de púrpura fulminans e equimoses disseminadas, entrando em estado de choque refratário e falecendo duas horas após internaçäo. O estudo de necrópsia revelou os achados clássicos da síndrome de Waterhouse-Frederichsen, servindo o caso para demonstrar as características clínicas, patogênicas e anatomopatológicas do mais grave espectro clínico da doença meningocócica
Subject(s)
Adult , Humans , Female , Meningitis, Meningococcal , Waterhouse-Friderichsen Syndrome , Autopsy , Meningitis, Meningococcal/pathology , Waterhouse-Friderichsen Syndrome/pathologyABSTRACT
A propósito de la presentación de un caso, se señalan los aspectos esenciales de la enfermedad meningocóccica. Las manifestaciones cutáneas incluyen fenómenos de coagulación intravascular diseminada (CID) por posibles efectos endotoxínicos sobre los vasos sanguíneos y otras, por acción directa del miningococo en la piel. El fenómeno de púrpura fulminante está condicionado por bajos niveles de trombocitos circulantes y otros que se consideran como posibles variantes de la reacción generalizada de Schwartzman, asociada con liberación endotonica de bacterias y la ya mencionada CID