title: Streptococcus Pneumoniae Detection Long Time After Death in a Fatal Case of Waterhouse-Friderichsen Syndrome.
abstract: We report a fatal case of Waterhouse-Friderichsen syndrome in a 64-year-old man. The diagnosis, suspected during the autopsy (performed 63 hours after death), was confirmed through the successful detection of Streptococcus pneumoniae DNA and antigens in samples (blood and liver) collected during the autopsy. These results conformed with blood cultures performed antemortem, which became available only the day after the autopsy. The case underlines the need to collect biological material (liver and blood samples) during autopsy for microbiological investigations, although the collection is performed a long time after the death, suggesting that a liver sample works for DNA and liver and blood work for Streptococcus pneumoniae antigen detection.
authors.affiliation: From the *Forensic Medicine Unit, Section of Public Health and Human Sciences, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, and †Microbiology Section, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Verzeletti
authors.forename: Carlo
authors.initials: C
authors.lastname: Bonfanti
authors.forename: Anna
authors.initials: A
authors.lastname: Leide
authors.forename: Elena
authors.initials: E
authors.lastname: Azzalini
authors.forename: Maria Antonia
authors.initials: MA
authors.lastname: De Francesco
authors.forename: Giorgio
authors.initials: G
authors.lastname: Piccinelli
authors.forename: Francesco
authors.initials: F
authors.lastname: De Ferrari
mesh_terms: D000311:Adrenal Glands / Q000473:pathology; D004269:DNA, Bacterial / Q000302:isolation & purification; D017809:Fatal Outcome; D006801:Humans; D008099:Liver / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000150:complications*; D013156:Splenectomy; D013296:Streptococcus pneumoniae / Q000235:genetics / Q000302:isolation & purification*; D014884:Waterhouse-Friderichsen Syndrome / Q000175:diagnosis*
chemical_list: D004269:DNA, Bacterial