NCJ Number
132523
Journal
Journal of Forensic Sciences Volume: 36 Issue: 5 Dated: (September 1991) Pages: 1485-1491
Date Published
1991
Length
7 pages
Annotation
The clinical, pathologic, and virulence features of a series of sudden deaths due to Group A beta-hemolytic streptococcus are presented.
Abstract
Sudden unexpected deaths form a large population of medical examiner caseloads. These presentations are unusual in that the interval between the onset of symptoms and death is very short, that the clinical history does not suggest an infectious etiology, and that the autopsy findings may be dramatic. The diagnosis of death due to this streptococcal group is dependent on postmortem cultures; without them these findings and histories would be easily misinterpreted. The microbiological features of the organism, including the M and T antigen typing and exotoxins, may explain its behavior, and the changing characteristics of the organism may account for case clustering and its virulent nature. Differential diagnosis includes blunt force trauma, burn injury, allergic reaction, poisoning, and infection. The determination of the cause of sudden death includes an algorithm of the patient history, external and gross examination, microscopic examination, and toxicological analysis. The postmortem cultures are not only imperative in selected cases to determine the accurate cause of death, but also serve an important epidemiological function. Recent publicity has led to a heightened public awareness of this unusually virulent bacteria. 1 figure and 15 references (Author abstract modified)