ABSTRACT
We report for the first time the use of coaxial cutting needle biopsy, guided by post-mortem computed tomography (PMCT), to sample internal body tissues for bacterioplankton PCR analysis to investigate drowning. This technical report describes the biopsy technique, the comparison of the needle biopsy and the invasive autopsy sampling results, as well as the PMCT and autopsy findings. By using this new biopsy sampling approach for bacterioplankton PCR, we have developed on previous papers describing the minimally invasive PMCT approach for the diagnosis of drowning. When such a system is used, the operator must take all precautions to avoid contamination of the core biopsy samples due to the sensitivity of PCR-based analytic systems.
Subject(s)
Aeromonas/genetics , Biopsy, Needle/methods , DNA, Bacterial/isolation & purification , Drowning/diagnosis , Aged, 80 and over , Brain/diagnostic imaging , Brain/microbiology , Brain/pathology , Humans , Kidney/diagnostic imaging , Kidney/microbiology , Kidney/pathology , Lung/diagnostic imaging , Lung/microbiology , Lung/pathology , Male , Polymerase Chain Reaction , Radiography, Interventional , Spleen/diagnostic imaging , Spleen/microbiology , Spleen/pathology , Tomography, X-Ray Computed , Whole Body ImagingABSTRACT
Bodies found immersed in water can pose difficulties to the investigating authorities. Pathologists may be assisted with the diagnosis by the use of tests such as the analysis for diatoms or the levels of strontium in the blood, although there is a recognised level of uncertainty associated with these tests. Recent work from Japan has shown that using molecular approaches, most recently real-time polymerase chain reaction (PCR) assays with TaqMan probes for bacterioplankton, it is possible to undertake rapid, less laborious, high throughput tests to differentiate freshwater from marine bacterioplankton and in doing so provide a molecular diagnostic test to assist in the diagnosis of drowning. We report the experiences of a United Kingdom forensic pathology unit in the use of this PCR based system for the diagnosis of drowning. We applied this technique to 20 adult and child cadavers from 4 bath, 12 freshwater, 2 brackish and 2 salt water scenes both from within the United Kingdom and abroad. Drowning was concluded to be the cause of death in 16 of these 20 cases and the PCR method supported this conclusion in 12 of these 16 cases. The PCR did not provide evidence of drowning in the four cases where death was from other causes. We illustrate that this PCR method provides a rapid diagnostic supportive test for the diagnosis of drowning that can be applied to United Kingdom autopsy practice.
