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Forensic Evaluation of Sudden Death Due to Tuberculosis

NCJ Number
Journal of Forensic Sciences Volume: 53 Issue: 4 Dated: July 2008 Pages: 962-970
Klara Toro Ph.D.; Arpad Meszaros Ph.D.; Eva Kellar Ph.D.
Date Published
July 2008
9 pages
This paper reports on a case from Budapest (Hungary) that involved a medico-legal autopsy of a 50-year-old decedent, which determined that the cause of death was pulmonary tuberculosis (TB).
The diagnosis following autopsy was sudden death caused by TB complications by hemoptysis and hemorrhagic shock. The autopsy found bilateral pleural adhesions and many TB nodules diffusely bilateral cavernous in lungs; bronchioles were hardened and dilated, and the pleura and peritoneum showed multiple small yellowish white tubercles. Liver and kidney were congested; cardiomegaly (weight 520 g) was observed with dilated right ventricle. There was no evidence for any violent cause of death, and the connection between external damage and fatal outcome was excluded. Microscopic findings showed many foci of caseous necrosis with Langerhans’ giant cells in the lungs. Tubercle bacilli were found in the lungs by Ziehl-Neelsen staining. No immunological evidence for HIV infection was found. Toxicology tests for drugs were negative. The initial investigation at the scene (a street in Budapest) led to a suspicion of homicide. The face and surface of the body were covered by dry blood, and the pavement near the body was covered in blood. External examination showed several fresh bruises and injuries on the face and knee. On the left eye, there was subconjunctival petechial hemorrhage. In addition to presenting this case study of a sudden death due to pulmonary TB, this paper provides data and a discussion on TB as a re-emerging leading killer worldwide among infectious or communicable diseases, with drug-resistant TB posing a major threat to TB control efforts. 1 table, 3 figures, and 19 references