Fulminant sepsis due to anaerobic bacterial infection in immuno-compromised state.
We experienced two autopsy cases of fulminant sepsis due to anaerobes. Case 1: A 67-year-old female with uncontrolled diabetes mellitus (DM) was admitted to a hospital because of sudden onset of mid-abdominal pain. She was diagnosed with infectious colitis and given a laxative and an enema. However, 9h later, her blood pressure suddenly dropped with metabolic acidosis, and she died 20 h after admission. Autopsy revealed massive pneumohemia and a dark-brown colored mucosal surface from the terminal ileum to the sigmoid colon. Histopathological findings were compatible with marginal ischemic colitis. Anaerobes were positive in blood culture. Case 2: A 53-year-old male with alcoholic liver cirrhosis (LC) was found dead in his room. He had been alive 24 h before the discovery, but postmortem changes appeared to accelerate more rapidly than usual cases. Autopsy revealed severe LC with muddy ascites and many Gram-negative rods in several organs. These cases suggest the possibility of sepsis as causes of death, especially in immuno-compromised hosts when unexplained putrefactive changes are seen on forensic autopsy.
Suzuki
Hideto
H
Division of Forensic Medicine, Center for Community Medicine, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. atsushis@jichi.ac.jp
Murata
Kazumoto
K
Sakamoto
Atsushi
A
D000368:Aged; D017091:Colitis, Ischemic / Q000473:pathology; D003106:Colon / Q000473:pathology; D048909:Diabetes Complications; D005260:Female; D049429:Forensic Pathology; D006089:Gram-Negative Anaerobic Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D016867:Immunocompromised Host; D008099:Liver / Q000473:pathology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000382:microbiology*; D013927:Thrombosis / Q000473:pathology; D014684:Venae Cavae / Q000473:pathology