Postmortem diagnostics using MSCT and MRI of a lethal streptococcus group A infection at infancy: a case report.
Postmortem cross-sectional imaging using multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) was considered as a base for a minimal invasive postmortem investigation in forensic medicine such as within the Virtopsy approach. We present the case of a 3-year-old girl with a lethal streptococcus group A infection and the findings of postmortem imaging in this kind of natural death. Postmortem MSCT and MRI revealed an edematous occlusion of the larynx at the level of the vocal cords, severe pneumonia with atelectatic parts of both upper lobes and complete atelectasis of both lower lobes, purulent fluid-filled right main bronchus, enlargement of cervical lymph nodes and pharyngeal tonsils, and additionally, a remaining glossopharyngeal cyst as well as an ureter fissus of the right kidney. All relevant autopsy findings could be obtained and visualized by postmortem imaging and confirmed by histological and microbiological investigations supporting the idea of a minimal invasive autopsy technique.
Jackowski
Christian
C
Institute of Forensic Medicine, University of Bern, IRM-Buehlstrasse 20, CH-3012 Bern, Switzerland. christian.jackowski@irm.unibe.ch
Dirnhofer
Stephan
S
Thali
Michael
M
Aghayev
Emin
E
Dirnhofer
Richard
R
Sonnenschein
Martin
M
D000234:Adenoids / Q000473:pathology; D001991:Bronchitis / Q000382:microbiology / Q000473:pathology; D002675:Child, Preschool; D003560:Cysts / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D049429:Forensic Pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007829:Laryngostenosis / Q000382:microbiology / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology; D008279:Magnetic Resonance Imaging; D010608:Pharyngeal Diseases / Q000473:pathology; D018410:Pneumonia, Bacterial / Q000473:pathology; D001261:Pulmonary Atelectasis / Q000382:microbiology / Q000473:pathology; D013290:Streptococcal Infections / Q000175:diagnosis*; D013297:Streptococcus pyogenes; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014060:Tongue Diseases / Q000473:pathology; D014513:Ureter / Q000002:abnormalities