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Lethal Infections, Sepsis, and Shock

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Abstract

A wide range of potentially fatal infections can be considered in cause-of-death investigations. In addition to common fatal infections, such as the various forms of pneumonia (viral pneumonia, purulent bronchopneumonia, lobar pneumonia), histopathological investigations can help to determine rare pneumonia pathogens (fungal pneumonia, Pneumocystis jirovecii infection, pulmonary tuberculosis, etc.). Other possible fatal infections include purulent pancreatitis, ascending cholangitis, clostridial infection, measles, echinococcosis, purulent ascending pyelonephritis, glomerulonephritis, and overwhelming postsplenectomy infection (OPSI) syndrome. Although histopathology often reveals nonspecific evidence of shock, it is also often able to identify the cause of shock. Fatal infections and sepsis can occur in conjunction with medical interventions (e.g., infected implants); however, signs of shock are also seen in anaphylactic shock, where attention needs to be paid as much to increased eosinophil granulocytes as to degranulated mast cells. Depending on the geographical region, pathogens such as leptospirosis and malaria can also be included in possible causes-of-death considerations.

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References

  • Albert S, Schröter A, Bratzke H, Brade V (1995) Postmortem diagnosis of falciparum malaria. Dtsch Med Wochenschr 120:18–22

    Article  PubMed  CAS  Google Scholar 

  • An JL, Ishida Y, Kimura A, Tsokos M, Kondo T (2009) Immunohistochemical detection of CCR2 and CX3CR1 in sepsis-induced lung injury. Forensic Sci Int 192:e21–e25

    Article  PubMed  CAS  Google Scholar 

  • Andes WA (1982) Spontaneous clostridial sepsis and sudden death. South Med J 75:378–379

    Article  PubMed  CAS  Google Scholar 

  • Ansari MQ, Zamora JL, Lipscomb MF (1993) Postmortem diagnosis of acute anaphylaxis by serum tryptase analysis. Am J Clin Pathol 99:101–103

    Article  PubMed  CAS  Google Scholar 

  • Barnard JH (1967) Allergic and pathologic findings in fifty insect-sting fatalities. J Allergy 40:107–114

    Article  PubMed  CAS  Google Scholar 

  • Becker K, Ortmann C, Bajanowski T, Brinkmann B, Peters G (1999) Use of polymerase chain reaction for post-mortem diagnosis of malaria. Diagn Mol Pathol 8:211–215

    Article  PubMed  CAS  Google Scholar 

  • Beh P, Byard RW (2015) Diptheria and lethal upper airway obstruction. Forensic Sci Med Pathol 11:133–135

    Article  PubMed  Google Scholar 

  • Bennis A, Darif A, Mehadji BE, Chraibi N (2000) Cardiac hydatid cyst revealed by the complete heart block. Heart Vessel 15:46–48

    Article  CAS  Google Scholar 

  • Bisno AL (1971) Hyposplenism and overwhelming pneumococcal infection, a reappraisal. Am J Med Sci 262:101

    Article  PubMed  CAS  Google Scholar 

  • Brandt G (1980) Pathohistologische Diagnostik der Gewebsformen einheimischer Mykosen. Pathologe 1:100–105

    PubMed  CAS  Google Scholar 

  • Buris L, Szabó M, Kelemen J (1963) Hamman-Rich-Syndrom beim plötzlichen Tod. Dtsch Z Gesamte Gerichtl Med 54:211–216

    PubMed  CAS  Google Scholar 

  • Burke MP, Opeskin K (1999) Nontraumatic clostridial myonecrosis. Am J Forensic Med Pathol 20:158–162

    Article  PubMed  CAS  Google Scholar 

  • Butcovan D, Grigoriu C, Astărăstoae V (2010) Cardiac echinococcosis causing unexpected death. A case report. Rom J Leg Med 18:189–192

    Article  Google Scholar 

  • Byard RW (2009) An analysis of possible mechanisms of unexpected death occurring in hydatid disease (Echinococcosis). J Forensic Sci 54:919–922

    Article  PubMed  Google Scholar 

  • Byard RW (2016) Gross and microscopic features of extensive subcutaneous emphysema. Forensic Sci Med Pathol 12:372–375

    Article  PubMed  Google Scholar 

  • Carson HJ, Cook BA (2009) Mast cell tryptase in a case of anaphylaxis due to repeat antibiotic exposure. Legal Med 11:234–236

    Article  PubMed  CAS  Google Scholar 

  • Clausnitzer H, Müntefering H (1975) Ein Fall von Goodpasture-Syndrom in der gerichtsärztlichen Praxis. Z Rechtsmed 76:245–251

    Article  PubMed  CAS  Google Scholar 

  • Curti AJ, Lin JH, Szabo K (1985) Overwhelming post-splenectomy infection with Plesiomonas shigelloides in a patient cured of Hodgkin’s disease. Am J Clin Pathol 83:522–524

    Article  PubMed  CAS  Google Scholar 

  • Da Broi U, Moreschi C (2011) Post-mortem diagnosis of anaphylaxis: a difficult task in forensic medizince. Forensic Sci Int 204:1–5

    Article  CAS  PubMed  Google Scholar 

  • Dean HR (1922) Histology of a case of anaphylactic shock. J Pathol Bacteriol 25:305–315

    Article  Google Scholar 

  • De-Georgia F, Lodise M, Pascali VL, Spagnolo AG, d’Aloja E, Arena V (2015) An unusual case showing fatal rupture of a gastric ulcer or gastromalacia acida? The importance/role of histology for differential diagnosis. J Forensic Sci 60:240–242

    Article  Google Scholar 

  • Delage C, Irey NS (1972) Anaphylactic deaths. A clinicopathologic study of 43 cases. J Forensic Sci 17:525–540

    Article  PubMed  CAS  Google Scholar 

  • Delage C, Mullick FG, Irey NS (1973) Myocardial lesions in anaphylaxis. A histochemical study. Arch Pathol 95:185–189

    PubMed  CAS  Google Scholar 

  • Dempers J, Sens MA, Wadee SA, Kinney HC, Odendaal HJ, Wright CA (2011) Progressive primary pulmonary tuberculosis presenting as the sudden unexpected death in infancy: a case report. Forensic Sci Int 206:e27–e30

    Article  PubMed  Google Scholar 

  • Dettmeyer R (2006) Malaria tropica: Bericht zu einer Erkrankung mit tödlichem Ausgang. Robert Koch Institut. Epidemiologisches Bulletin, p 51

    Google Scholar 

  • Dettmeyer R, Varchmin-Schultheiß K, Madea B (1999) Postpartales letales OPSI-Syndrom bei posttraumatischer Splenosis peritonei. In: 8th spring-meeting of the German society of forensic medicine – northern region, Hamburg, 7–8 May 1999

    Google Scholar 

  • Diamond I (1958) The Hamman-Rich syndrome in childhood. Pediatrics 22:27

    Google Scholar 

  • Diamond LK (1969) Splenectomy in childhood and the hazard of overwhelming infection. Pediatrics 43:886–889

    PubMed  CAS  Google Scholar 

  • Diaz T, Martinez T, Antepara I, Usandizaga JM, Lopez Valverde M, Jaurequi I (1996) Latex allergy as a risk during delivery. Br J Obstet Gynaecol 103:173–175

    Article  PubMed  CAS  Google Scholar 

  • Dickerman JD (1979) Splenectomy and sepsis. Pediatrics 63:938–941

    PubMed  CAS  Google Scholar 

  • Draisci G, Nucera E, Pollastrini E, Forte E, Zanfini B, Pinto R, Patriarca G, Schiavino D, Pietrini D (2007) Anaphylactic reactions during cesarean section. Int J Obstet Anesth 16:63–67

    Article  PubMed  CAS  Google Scholar 

  • Edler C, Klein A, Gehl A, Ilchman C, Scherpe S, Schrot M (2011) The new influenza A (H1N1/09): symptoms, diagnostics, and autopsy results. Int J Legal Med 125:157–161

    Article  PubMed  Google Scholar 

  • Edston E, van Hage-Hamsten M (1998) ß-Tryptase measurements post-mortem in anaphylactic deaths and in controls. Forensic Sci Int 93:135–142

    Article  PubMed  CAS  Google Scholar 

  • Edston E, van Hage-Hamsten M (2003) Death in anaphylaxis in a man with house dust mite allergy. Int J Legal Med 117:299–301

    Article  PubMed  Google Scholar 

  • Edston E, van Hage-Hamsten M (2005) Postmortem diagnosis of anaphylaxis. In: Tsokos M (ed) Forensic pathology reviews, vol 3. Humana Press, Totowa, pp 267–281

    Chapter  Google Scholar 

  • Edston E (2013) Accumulation of eosinophils, mast cells, and basophils in the spleen in anaphylactic deaths. Forensic Sci Med Pathol 9:496–500

    Article  PubMed  Google Scholar 

  • Fineschi V, Monasterolo G, Rosi R, Turillazzi E (1999) Fatal anaphylactic shock during a fluorescein angiography. Forensic Sci Int 100:137–142

    Article  CAS  PubMed  Google Scholar 

  • Fracasso T, Jentgens L, Pfeiffer H, Sauerland C, Mangin P, Schmeling A (2016) Right heart ischemia in cases of sepsis. Forensic Sci Int 259:106–109

    Article  PubMed  CAS  Google Scholar 

  • Gerber JE, Johnson JE, Scott MA, Madhusudhan KT (2002) Fatal meningitis and encephalitis due to bartonella henselae bacteria. J Forensic Sci 47:640–644

    PubMed  Google Scholar 

  • Glenner GG, Cohen LA (1960) Histochemical demonstration of species-specific trypsin-like enzyme in mast cells. Nature 105:846–847

    Article  Google Scholar 

  • Goodpasture EW (1919) The significance of certain pulmonary lesions in relation to the etiology of influenza. Am J Med Sci 158:863

    Article  Google Scholar 

  • Grinblat J, Gilboa A (1975) Overwhelming pneumococcal sepsis 25 years after splenectomy. Am J Med Sci 270:523

    Article  PubMed  CAS  Google Scholar 

  • Hausmann R, Albert F, Geißdörfer W, Betz P (2004) Clostridium fallax associated with sudden death in a 16-year-old boy. J Med Microbiol 53:581–583

    Article  PubMed  Google Scholar 

  • Heinze S, Erbersdobler A, Tsokos M (2010) Todesursache: anaphylaxie. Rechtsmedizin 20:282–284

    Article  Google Scholar 

  • Heinze S, Püschel K, Tsokos M (2011) Necrotizing fasciitis with fatal outcome: a report of two cases. Forensic Sci Med Pathol 7:278–282

    Article  PubMed  Google Scholar 

  • Holdsworth RJ, Irving AD, Cuschieri A (1991) Postsplenectomy sepsis and its mortality rate. Actual versus perceived risks. Br J Surg 78:1031–1038

    Article  PubMed  CAS  Google Scholar 

  • Ihama Y, Fukasawa M, Ninomiya K, Kawakami Y, Nagai T, Fuke C, Miyazaki T (2014) Anaphylactic shock caused by sting of crown-of-thorns starfish (Acanthaster planci). Forensic Sci Int 236:e5–e8

    Article  PubMed  Google Scholar 

  • Jänisch S, Günther D, Fieguth A, Bange FC, Schmidt A, Debertin AS (2010) Postmortal detection of clostridia – putrefaction or infection? Arch Kriminol 225:99–108

    PubMed  Google Scholar 

  • Janssen W (1977) Forensische histologie. Schmidt-Römhild, Lübeck, pp 189–216

    Google Scholar 

  • Johansson O, Virtanen M, Hilliges M, Yang Q (1992) Histamine immunohistochemistry: a new and highly sensitive method for studying cutaneous mast cells. Histochem J 24:283–287

    Article  PubMed  CAS  Google Scholar 

  • Jorgensen P, Heiden M, Kern P, Schöneberg I, Krause G, Alpers K (2008) Underreporting of human alveolar echinococcosis, Germany. Emerg Infect Dis 14:935–937

    Article  PubMed  PubMed Central  Google Scholar 

  • Kanthan R, Moyana T, Nyssen J (1999) Asplenia as a cause of sudden unexpected death in childhood. Am J Forensic Med Pathol 20:57–59

    Article  PubMed  CAS  Google Scholar 

  • Kaplan M, Demirtas M, Cimen S, Ozler A (2001) Cardiac hydatid cyst with intracavitary expansion. Ann Thorac Surg 71:2034–2035

    Article  Google Scholar 

  • Kernbach-Wighton G, Böhnel H, Saternus KS (2003) Zur Phänomenologie beim positiven Clostridien-Nachweis. Rechtsmedizin 13:86–90

    Article  Google Scholar 

  • Kounis NG, Soufras GD, Kounis GN, Hahalis G (2013) Suicidal anaphylactic death: is Kounis anaphylaxis associated syndrome the cause? Forensic Sci Int 232:e42–e43

    Article  PubMed  Google Scholar 

  • Kounis NG (2013) Coronary hypersensitivity disorder: the Kounis syndrome. Clin Ther 35:563–571

    Article  PubMed  Google Scholar 

  • Kounis NG, Soufras GD, Hahalis G (2014) Accumulation of eosinophils, mast cells, and basophils in the spleen and the coronary arteries in anaphylactic deaths: is the Kounis hypersensitivity associated syndrome present? Forensic Sci Med Pathol 10:150–151

    Article  PubMed  Google Scholar 

  • Kribben A, Uppenkamp A, Heeman U, Höffkes HG, Meusers P (1995) Postsplenektomie-sepsis (OPSI-Syndrom). Dtsch Med Wochenschr 120:771–775

    Article  PubMed  CAS  Google Scholar 

  • Kucukarslan N, Savas Oz B, Demirkilic U, Tatar H (2005) An asymptomatic cardiac echinococcus cyst case. Int J Thor Cardiovasc Surg 74:37–42

    Google Scholar 

  • Kühn H, Kleinfeld F, Pfeifer B (1983) Über das Opsi-Syndrom. Pathologe 4:112–116

    PubMed  Google Scholar 

  • Landi KK, Coleman T (2008) Sudden death in toddlers caused by influenza B infection: a report of two cases and a review of the literature. J Forensic Sci 53:213–215

    Article  PubMed  Google Scholar 

  • Lau G (2005) Iatrogenic injury. A forensic perspective. In: Tsokos M (ed) Forensic pathology reviews, vol 3. Humana Press, Totowa, pp 351–439

    Chapter  Google Scholar 

  • Lau G, Lai SH (2008) Forensic histopathology. In: Tsokos M (ed) Forensic pathology reviews, vol 5. Humana Press, Totowa, pp 239–265

    Chapter  Google Scholar 

  • Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, Cohen J, Opal SM, Vincent JL, Ramsay G (2003) 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definition conference. Crit Care Med 31:1250–1256

    Article  PubMed  Google Scholar 

  • Lindblad BE, Lindblad LN (1990) Fatal pneumococcal bacteremia with disseminated intravascular coagulation and Waterhouse-Friderichsen syndrome in a vaccinated, splenectomized adult. Case report. Acta Chir Scand 156:487–488

    PubMed  CAS  Google Scholar 

  • Locker GJ, Wagner A, Peter A, Staudinger T, Marosi C, Rintelen C, Knapp S, Malzer K, Weiss K, Metnitz P (1995) Lethal Waterhouse-Friderichsen syndrome in post-traumatic asplenia. J Trauma 39:784–786

    Article  PubMed  CAS  Google Scholar 

  • Luchini D, Meacci F, Oggioni MR, Morabito G, D’Amato V, Gabrielli M, Pozzi G (2008) Molecular detection of Leptospira interrogans in human tissues and environmental samples in a lethal case of leptospirosis. Int J Legal Med 122:229–233

    Article  PubMed  CAS  Google Scholar 

  • Lunetta P, Penttila A, Salovaara R, Sajantila A (2002) Sudden death due to rupture of the arteria pancreatica magna: a complication of an immature pseudocyst in chronic pancreatitis. Int J Legal Med 116:43–46

    Article  PubMed  CAS  Google Scholar 

  • Mahfoud B, Heinemann A, Püschel K (2002) Nekrotisierende Myositis durch Clostridium perfringens nach intravenöser Heroinapplikation. Rechtsmedizin 12:109–111

    Article  Google Scholar 

  • Mayer DE, Krauskopf A, Hemmer W, Moritz K, Jarisch R, Reiter C (2011) Usefulness of post mortem determination of serum tryptase, histamine and diamine oxidase in the diagnosis of fatal anaphylaxis. Forensic Sci Int 212:96–101

    Article  PubMed  CAS  Google Scholar 

  • McCaughey WTE, Thomas BJ (1962) Pulmonary hemorrhage and glomerulonephritis. The relation of pulmonary hemorrhage to certain types of glomerular lesions. Am J Clin Pathol 38:577

    Article  PubMed  CAS  Google Scholar 

  • Metter D, Schulz E (1977) Die forensische Begutachtung iatrogener Gasbrandinfektionen. Beitr Gerichtl Med 35:47–54

    PubMed  CAS  Google Scholar 

  • Miyashita T, Kakimoto N, Ishida Y, Hayashi T, Kimura A, Tsokos M, Kondo T (2006) Immunohistochemical expression of tumor necrosis factor-α in sepsis-induced lung injury. Forensic Sci Med Pathol 2:103–108

    Article  PubMed  Google Scholar 

  • Molz G, Hartmann HP, Griesser HR (1986) Generalisierte BCG-Infektion bei einem 7 Wochen alten, plötzlich verstorbenen Säugling. Pathologe 7:216–221

    PubMed  CAS  Google Scholar 

  • Muciaccia B, Sestili C, de Grossi S, Vestri A, Cipolloni L, Cecchi R (2016) Are mast cells implicated in asphyxia? Int J Legal Med 130:153–161

    Article  PubMed  Google Scholar 

  • Müller AM, Tsokos M (2006) Pathology of human endothelium in septic organ failure. In: Tsokos M (ed) Forensic pathology reviews, vol 4. Humana Press, Totowa, pp 161–192

    Chapter  Google Scholar 

  • Müller R, Korb G, Gedigk P (1970) Über zentrale Nekrosen in der Leber nach einem Schock. Verh Dtsch Ges Pathol 54:511

    PubMed  Google Scholar 

  • Müller AM, Gruhn KM, Herwig MC, Tsokos M (2008) VE-cadherin and ACE: markers for sepsis in post mortem examination? Legal Med 10:257–263

    Article  PubMed  CAS  Google Scholar 

  • Murphy TE, Kean BH, Venturini A, Lillehei CW (1971) Echinococcus cyst of the left ventricle: report of a case with review of the pertinent literature. J Thorac Cardiovasc Surg 61:443–450

    PubMed  CAS  Google Scholar 

  • Naeve W (1971) Zum histologischen Nachweis einer akuten Malaria tropica an fäulnisveränderten Organen. Z Rechtsmed 69:210–216

    Article  PubMed  CAS  Google Scholar 

  • Ondruschka B, Habeck JO, Hädrich C, Dreßler J, Bayer R (2015) Rare cause of natural death in forensic setting: hemophagocytic syndrome. Int J Legal Med 130:777–781. https://doi.org/10.1007/s00414-015-1305-0

    Article  PubMed  Google Scholar 

  • Ortiz-Rey JA, Suárez-Peñaranda JM, San Miguel P, Muñoz JI, Rodríguez-Calvo MS, Concheiro L (2008) Immunohistochemical analysis of P-Selectin as a possible marker of vitality in human cutaneous wounds. J Forensic Legal Med 15:368–372

    Article  CAS  Google Scholar 

  • Ortmann C, Brinkmann B (1997) The expression of P-selectin in inflammatory and non-inflammatory lung tissue. Int J Legal Med 110:155–158

    Article  PubMed  CAS  Google Scholar 

  • Ortmann C, Pfeiffer H, Brinkmann B (2000) Demonstration of myocardial necrosis in the presence of advanced putrefaction. Int J Legal Med 114:50–55

    Article  CAS  PubMed  Google Scholar 

  • Osawa M, Satoh F, Horiuchi H et al (2008) Postmortem diagnosis of fatal anaphylaxis during intravenous administration of therapeutic and diagnostic agents: evaluation of clinical laboratory parameters and immunohistochemistry in three cases. Legal Med 10:143–147

    Article  CAS  PubMed  Google Scholar 

  • Pavelites JJ, Prahlow JA (2011) Fatal human monocytic ehrlichiosis: a case study. Forensic Sci Med Pathol 7:287–293

    Article  PubMed  Google Scholar 

  • Peabody JW, Buechner HH, Anderson HE (1955) Hamman-Rich syndrome. Arch Intern Med 43:1127

    Google Scholar 

  • Perskvist N, Edston E (2007) Differential accumulation of pulmonary and cardiac mast-cell-subsets and eosinophils between fatal anaphylaxis and asthma death: a postmortem comparative study. Forensic Sci Int 169:43–49

    Article  CAS  PubMed  Google Scholar 

  • Plenzig S, Döring C, Held H, Verhoff MA (2016) On the wrong track. Death of a drug abuser in a penitentiary due to desquamative interstitial pneumonia. Rechtsmedizin 26:440–443

    Article  Google Scholar 

  • Popper HH, Pailer S, Wurzinger G, Feldner H, Hesse C, Eber E (2002) Expression of adhesion molecules in allergic lung diseases. Virchows Arch 440:172–180

    Article  PubMed  CAS  Google Scholar 

  • Prahlow JA, Barnard JJ (1998) Fatal anaphylaxis due to fire and stings. Am J Forensic Med Pathol 19:137–142

    Article  PubMed  CAS  Google Scholar 

  • Preuss J, Dettmeyer R, Strehler M, Madea B (2006a) Unerkannt akut-letale Infektionen. Ursachen plötzlicher Todesfälle im Erwachsenenalter. Rechtsmedizin 16:165–171

    Article  Google Scholar 

  • Preuss J, Dettmeyer R, Madea B (2006b) Tödlich verlaufende, postoperative Peritonitiden. Rechtsmedizinische Begutachtung. Rechtsmedizin 16:383–388

    Article  Google Scholar 

  • Pumphrey RSH, Roberts ISD (2000) Postmortem findings after fatal anaphylactic reactions. J Clin Pathol 53:273–276

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Püschel K, Lockemann U, Dietrich M (1998) Recurrent fatal outcome of malaria infections due to late diagnosis. Dtsch Ärztebl 95:2697–2700

    Google Scholar 

  • Ramsay LE, Bouskill KC (1973) Fatal pneumococcal meningitis in adults following splenectomy: two case reports and a review of the literature. J R Nav Med Serv 59:102–114

    PubMed  CAS  Google Scholar 

  • Ramsthaler F, Verhoff MA, Gehl A, Kettner M (2010) The novel H1N1/swine-origin influenza virus and its implications for autopsy practice. Int J Legal Med 124:171–173

    Article  PubMed  Google Scholar 

  • Randall B, Butts J, Halsey JF (1995) Elevated post-mortem tryptase in the absence of anaphylaxis. J Forensic Sci 40:208–211

    Article  PubMed  CAS  Google Scholar 

  • Rauch E, Tutsch-Bauer E, Penning R (1999) Malaria tropica – a problem in forensic medicine? Rechtsmedizin 10:1–6

    Article  Google Scholar 

  • Reavy DT, Nakonechny D (1979) Sudden death and sepsis after splenectomy. J Forensic Sci 24:757–761

    Google Scholar 

  • Reggiani Bonetti L, Maccio L, Trani N, Radheshi E, Palmiere C (2015) Splenic hypereosinophilia in anaphylaxis-related death: different assessments depending on different types of allergens? Int J Legal Med 129:97–103

    Article  PubMed  Google Scholar 

  • Rimmer EF, Turberville C, Horton MA (1984) Human mast cells detected by monoclonal antibodies. J Clin Pathol 37:1249–1255

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Risse M, Verhoff MA, Lehmann H, Dettmeyer R (2008) Unerkannte letale Maserninfektion bei einem 14-jährigen Mädchen mit Trisomie 21. Rechtsmedizin 18:383–386

    Article  Google Scholar 

  • Rizzo M, Magro G, Castaldo P (2004) OPSI (overwhelming postsplenectomy infection) syndrome: a case report. Forensic Sci Int 164S:S55–S56

    Article  Google Scholar 

  • Rodriguez Gomez M, Oehler U, Helpap B (1997) Foudroyant verlaufende Sepsis nach Splenektomie. Pathologe 18:257–260

    Article  PubMed  CAS  Google Scholar 

  • Roncati L, Barbolini G, Scacchetti AT, Busani S, Maiorana A (2013) Unexpected death: anaphylactic intraoperative death due to Thymoglobulin carbohydrate excipient. Forensic Sci Int 228:e28–e32

    Article  PubMed  CAS  Google Scholar 

  • Ruf G, Kirchner R, Lausen M, Pelz K (1986) Die Clostridieninfektion der Galle. Chir Praxis 36:13–22

    Google Scholar 

  • Sampson HA (2000) Food anaphylaxis. Br Med Bull 56:925–935

    Article  PubMed  CAS  Google Scholar 

  • Sasaki T, Nanjo H, Takahashi M, Sugijama T, Ono I, Masuda H (2000) Non-traumatic gas gangrene in the abdomen: report of six autopsy cases. Gastroenterology 35:382–390

    CAS  Google Scholar 

  • Schumaker B Jr (1952) Splenic studies: I. Susceptibility to infection after splenectomy performed in infancy. Am Surg 136:239

    Google Scholar 

  • Seufert RM, Böttcher W (1982) Organerhaltende Behandlung von Milzverletzungen. Dtsch Med Wochenschr 107:523–526

    Article  PubMed  CAS  Google Scholar 

  • Shen Y, Li L, Grant J et al (2009) Anaphylactic deaths in Maryland (United States) and Shanghai (China): a review of forensic autopsy cases from 2004 to 2006. Forensic Sci Int 186:1–5

    Article  PubMed  Google Scholar 

  • Shintaku M, Sangawa A, Yonezawa A, Nasu K (2001) Aortic lesions in aspergillosis: histopathological study of two autopsy cases. Virchows Arch 439:640–644

    Article  PubMed  CAS  Google Scholar 

  • Simini B (1999) Liposuction surgery in Italy leads to Streptococcus pyogenes sepsis. Lancet 353:1164

    Article  Google Scholar 

  • Siveke J, Caselitz J, Püschel K (2001) Clinical and morphologic features of fatal falciparum malaria. Rechtsmedizin 11:82–88

    Article  Google Scholar 

  • Soper DE (1986) Clostridial myonecrosis arising from an episiotomy. Obstet Gynecol 68(3 Suppl):26S–28S

    PubMed  CAS  Google Scholar 

  • Sterzig V, Wild V, Weishaupt J, Tatschner T, Babel B, Bohnert M (2016) Tod beim Hausarzt. Arch Kriminol 238:120–127

    Google Scholar 

  • Suzuki H, Murata K, Sakamoto A (2009) An autopsy case of fulminant sepsis due to pneumatosis cystoides intestinalis. Legal Med 11:S528–S530

    Article  PubMed  Google Scholar 

  • Telli HH, Durgut K (2001) Ruptured cardiac hydatid cyst masquerading as acute coronary syndrome: report of a case. Surg Today 31:908–911

    Article  PubMed  CAS  Google Scholar 

  • Thierauf A, Dettmeyer R, Wollersen H, Musshoff F, Madea B (2007) Fatal Candida tropicalis infection in an 8-month-old infant with an aplasia of the thymus as a rare cause of death in infancy. Forensic Sci Int 169:228–233

    Article  PubMed  Google Scholar 

  • Thu M, Winskong C, Byard RW (2014) Tuberculosis and sudden death. Forensic Sci Med Pathol 10:266–268

    Article  PubMed  Google Scholar 

  • Trani N, Reggiani Bonetti LR, Gualandri G, Barbolini G (2008) Immediate anaphylactic death following antibiotics injection: splenic eosinophilia easily revealed by pagoda red stain. Forensic Sci Int 181:21–25

    Article  CAS  PubMed  Google Scholar 

  • Tsokos M (2012) Syphilitic aortic aneurysm rupture as cause of sudden death. Forensic Sci Med Pathol 8:325–326

    Article  PubMed  Google Scholar 

  • Tsokos M (2003) Immunohistochemical detection of sepsis-induced lung injury in human autopsy material. Legal Med 5:73–86

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M (2004) Fatal respiratory tract infections with Mycoplasma pneumoniae. Histopathological features, aspects of post-mortem diagnosis and medicolegal implications. In: Tsokos M (ed) Forensic pathology reviews, vol 1. Humana Press, Totowa, pp 201–218

    Chapter  Google Scholar 

  • Tsokos M (2005) Pathology of sepsis. In: Rutty GN (ed) Essentials of autopsy practice, vol 3. Springer, London, pp 39–85

    Google Scholar 

  • Tsokos M (2006a) Postmortale Sepsisdiagnostik. Teil 1: Pathomorphologie. Rechtsmedizin 16:231–246

    Article  Google Scholar 

  • Tsokos M (2006b) Postmortale Sepsisdiagnostik. Teil 2: Immunhistochemie und biochemische Diagnostik. Rechtsmedizin 16:333–342

    Article  Google Scholar 

  • Tsokos M, Braun C (2007) Acute pancreatitis presenting as sudden, unexpected death: an autopsy-based study of 27 cases. Am J Forensic Med Pathol 28:267–270

    Article  PubMed  Google Scholar 

  • Tsokos M, Fehlauer F (2001) Post-mortem markers of sepsis: an immunohistochemical study using VLA-4 (CD49d/CD29) and ICAM-1 (CD54) for the detection of sepsis-induced lung injury. Int J Legal Med 114:291–294

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M, Püschel K (1999) Iatrogenic staphylococcus aureus septicaemia following intravenous and intramuscular injections: clinical course and pathomorphological findings. Int J Legal Med 112:303–308

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M, Fehlauer F, Püschel K (2000) Immunohistochemical expression of E-selectin in sepsis-induced lung injury. Int J Legal Med 113:338–342

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M, Reichelt U, Jung R, Nierhaus A, Püschel K (2001) Interleukin-6 and C-reactive protein serum levels in sepsis-related fatalities during the early post-mortem period. Forensic Sci Int 119:47–56

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M, Anders S, Paulsen F (2002) Lectin binding patterns of alveolar epithelium and subepithelial seromucous glands of the bronchi in sepsis and controls – an approach to characterize the non-specific immunological response of the human lung to sepsis. Virchows Arch 440:181–186

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M, Pufe T, Paulsen F, Anders S, Mentlein R (2003) Pulmonary expression of vascular endothelial growth factor in sepsis. Arch Pathol Lab Med 127:331–335

    PubMed  CAS  Google Scholar 

  • Tsokos M, Zöllner B, Feucht HH (2005) Fatal influenza A infection with Staphylococcus aureus superinfection in a 49-year-old woman presenting as sudden death. Int J Legal Med 119:40–43

    Article  PubMed  CAS  Google Scholar 

  • Tsokos M, Schalinski S, Paulsen F, Sperhake JP, Püschel K, Sobottka I (2008) Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases. Int J Legal Med 122:35–41

    Article  PubMed  Google Scholar 

  • Tümer AR, Dener C (2007) Diagnostic dilemma of sudden deaths due to acute hemorrhagic pancreatitis. J Forensic Sci 52:180–182

    Article  PubMed  Google Scholar 

  • Turillazzi E, Di Donato S, Neri M, Riezzo I, Fineschi V (2007) An immunohistochemical study in a fatal case of acute interstitial pneumonitis (Hamman-Rich syndrome) in a 15-year-old boy presenting as sudden death. Forensic Sci Int 173:73–77

    Article  PubMed  CAS  Google Scholar 

  • Turillazzi E, Greco P, Neri M, Pomara C, Riezo I, Fineschi V (2008) Anaphylactic latex reaction during anaesthesia: the silent culprit in a fatal case. Forensic Sci Int 179:e5–e8

    Article  PubMed  CAS  Google Scholar 

  • Unkrig S, Hagemeier L, Madea B (2010) Postmortem diagnosis of assumed food anaphylaxis in an unexpected death. Forensic Sci Int 198:e1–e4

    Article  PubMed  CAS  Google Scholar 

  • Urata Y, Hasegawa M, Hasegawa H, Shikano M, Kawashima S, Imoto M (1997) A fatal case of overwhelming postsplenectomy infection syndrome developing 10 years after splenectomy. Nihon Rinsho Meneki Gakkai Kaishi 20:184–190

    Article  PubMed  CAS  Google Scholar 

  • van Wyck DB, Witte MH, Witte CL, Thies AC (1980) Critical splenic mass for survival from experimental pneumococcemia. J Surg Res 28:14–17

    Article  PubMed  Google Scholar 

  • Vance BM, Strassmann G (1941) Sudden death following injection of foreign protein. Arch Pathol 34:849–865

    Google Scholar 

  • Walls AF, Bennett AR, McBride HM, Glennie MJ, Holgate ST, Church MK (1990a) Production and characterization of monoclonal antibodies specific for human mast cell tryptase. Clin Exp Allergy 20:581–589

    Article  PubMed  CAS  Google Scholar 

  • Walls AF, Jones DB, Williams JH, Church MK, Holgate ST (1990b) Immunohistochemical identification of mast cells in formaldehyde-fixed tissue using monoclonal antibodies specific for tryptase. J Pathol 162:119–126

    Article  PubMed  CAS  Google Scholar 

  • Weis A, Bohnert M (2008) Expression patterns of adhesion molecules P-selectin, von Willebrand factor and PECAM-1 in lungs: a comparative study in cases of burn shock and hemorrhagic shock. Forensic Sci Int 175:102–106

    Article  PubMed  CAS  Google Scholar 

  • White RB, Craighead JT (1957) Hamman-Rich syndrome. Dis Chest 31:335

    Article  PubMed  CAS  Google Scholar 

  • Worm M, Eckermann O, Dölle S, Aberer W, Beyer K, Hawranek T, Hompes S, Koehli A, Mahler V, Nemat K, Niggemann B, Pföhler C, Rabe U, Reissig A, Rietschel E, Scherer K, Treudler R, Ruëff F (2014) Triggers and treatment of anaphylaxis: an analysis of 4000 cases from Germany, Austria and Switzerland. Dtsch Ärztebl Int 111:367–375

    PubMed  PubMed Central  Google Scholar 

  • Yagmur G, Kara E, Yildirim M, Gurler AS, Eken AE, Babur C (2015) Two cases of malaria due to Plasmodium falciparum resulting in death: postmortem identification. Rom J Leg Med 23:33–36

    Article  Google Scholar 

  • Young RC, Bennett JE, Vogel CL, Carbone PP, DeVita VT (1970) Aspergillosis. The spectrum of the disease in 98 patients. Medicine 49:147–173

    Article  PubMed  CAS  Google Scholar 

  • Yunginger JW, Nelson DR, Squillace DL et al (1991) Laboratory investigation of deaths due to anaphylaxis. J Forensic Sci 36:857–865

    Article  PubMed  CAS  Google Scholar 

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Dettmeyer, R.B. (2018). Lethal Infections, Sepsis, and Shock. In: Forensic Histopathology. Springer, Cham. https://doi.org/10.1007/978-3-319-77997-3_15

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