Asymptomatic syphilitic massive necrosis of the spleen in late syphilis.

The varieties of luetic clinical variants are countless in nature. In this regard, an autopsy case of a 72-year-old homeless man who accidentally succumbed to carbon-monoxide poisoning is here presented and reviewed. The autopsy revealed the highly unusual finding of asymptomatic syphilitic necrosis of spleen followed by luetic mesaortitis, a solitary skin gumma, and syphilitic arthritis. The spleen was 8×4×3 cm in size; the capsule was completely calcified and firm, 3 to 5 mm thick. Only in the region of the hilus was a small part of preserved tissue found. After puncturing the capsule, a brown-yellowish pus-like mass was found which filled the entire space inside. When reviewing the relevant literature, this case and its finding of pan splenic necrosis accompanied by a calcified capsule seem to be unique in nature. In terms of the final diagnosis, a Treponema pallidum haemagglutination assay confirmed it to be syphilis. Since it was a late stage of the disease, it is estimated that it may have been present for more than 20 or 30 years in the deceased.

Using a Facebook profile in determining the motive of homicide.

Ritual homicides may be affective (emotional), but usually they are premediated, instrumental, or predatory. In the case under review, the Facebook profile of the assailant helped to determine the motive of the homicide, which seemed to be ritualistic in nature. Therein, a 56-year-old male sustained 48 stab wounds and other knife injuries. On the wall in a room above the body, a pentagram was drawn with the victim's blood, followed by a few words which can be associated with a "Satanic" ritual. Searching through the Facebook profile of the culprit, Satanism as a leading motive of the homicide was eventually excluded. The most interesting point of this case was the evaluation of a sentence used as a Facebook status, which greatly contributed to confirm the paedophilic nature of the murder.

Multiple stabbing in sex-related homicides.

It is possible that sexually driven homicides are the consequence of sexual deviation, but more often than not the main cause of such homicides stems from a non-paraphilic person's emotional component. It is known that homicides which involve multiple stabbing are very often the result of the assailant's highly expressed affect. This study tries to establish whether such homicides are essentially related to the sexual motives of the murderer. This paper is conducted through a retrospective autopsy study that includes 766 cases of homicides. These were reviewed and analysed according to the motive of the homicide, as well as by method, age, and gender of the victim, and the relationship between the victim and the assailant. The motives of homicides are classified as non-sexual and sexual, including homicides related to rape, jealousy, amorous affairs outside of an established relationship, deviant sexual behaviour of psychiatric patients, paraphilia, and disturbed emotional relationships between the victim and the assailant. Cases include both hetero- and homosexual relationships. Multiple stabbing occurs significantly more frequently in sex-related homicides (≥ 3 stab wounds) than in other homicide types. When the criteria for multiple stabbing are changed (≥ 4, 5, or 25 stab wounds), the percentage of sex-related homicides rises in every group in relation to the increased number of wounds. Sensitivity and specificity are represented by ROC curves for 3, 5 and 7 stab wounds. The correlation coefficients between multiple stabbing and sex-related homicides regarding gender are all near 0.9. For female victims, all homicides committed by 25 and more stab wounds were found to be sex-related. Statistically, jealousy was the most frequent motive for sex-related multiple stabbing homicides. Regardless of age, homicides involving multiple stabbings should be considered sex-related, especially when the victim is female.