RESUMEN
PURPOSE: To assess the diagnostic value of postmortem computed tomography (CT) in comparison to autopsy. MATERIALS AND METHODS: Twenty-seven cadavers were examined by sequential cranial CT and helical CT through the neck, thorax and abdomen and subsequently underwent an autopsy with histomorphologic examination of the pathologic specimens. The findings of CT, autopsy and histology were registered and compared by three radiologists and one specialist for forensic medicine, using a data entry form. RESULTS: In 19 of 27 cases, the findings explaining the cause of death were concordant for CT and autopsy. Intracranial, intraspinal and intracardiac gas accumulations (n = 12) were registered by CT alone. The detection of skull fractures was equal for both methods (n = 3). CT showed diagnostic problems in the assessment of pneumonic infiltrations (n = 16) and pulmonary edema (n = 21). CONCLUSION: CT is a useful and complementary method to autopsy.
Asunto(s)
Autopsia , Causas de Muerte , Medicina Legal , Cambios Post Mortem , Tomografía Computarizada por Rayos X , Adulto , Anciano , Anciano de 80 o más Años , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neumonía/diagnóstico por imagen , Neumonía/patología , Estudios Prospectivos , Edema Pulmonar/diagnóstico por imagen , Edema Pulmonar/patología , Fracturas Craneales/diagnóstico por imagen , Fracturas Craneales/patologíaRESUMEN
BACKGROUND: Despite the availability of antibiotics deep neck space infections with anaerobic germs (Ludwig's angina) still carry the potential for significant morbidity and mortality with delayed treatment. Usually, odontogenic infections with involvement of the submandibular space are the source of deep neck space infections in adults, whereas in the pediatric population the most common cause is acute tonsillitis with involvement of the peritonsillar space. During the second half of this century intravenous drug abusers appeared as a new group of patients at risk for deep neck space infections. When peripheral veins sclerosis the addicts feel it necessary to either inject subcutaneously or use the major vessels of the neck and groin. Intravenous drug abusers injecting the major vessels of the neck risk delayed diagnosis because of dissimulation of their injection practices. Dangerous complications of deep neck space infections may be the result. CASE: We report a clinical case with delayed diagnosis and fatal outcome. CONCLUSION: Intravenous drug abuse is a rare cause for deep neck space infections but should be considered when swelling of the neck soft tissue of uncertain cause is presented. The search for the diagnose should not keep from taking quick therapeutic steps.
Asunto(s)
Angina de Ludwig/etiología , Cuello , Infecciones de los Tejidos Blandos/etiología , Abuso de Sustancias por Vía Intravenosa/complicaciones , Adulto , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Humanos , Angina de Ludwig/diagnóstico , Angina de Ludwig/tratamiento farmacológico , Masculino , Radiografía Torácica , Choque Séptico/etiología , Infecciones de los Tejidos Blandos/diagnóstico , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Factores de Tiempo , Tomografía Computarizada por Rayos XRESUMEN
The authors report on a 21-year old female who died suddenly during a techno-festival. The autopsy findings and the results of chemical-toxicological analyses were not able to clear up the cause of death. Pathophysiological and toxicological considerations demonstrate that only a combination of facts are sufficient to explain the sudden death of this young woman.
Asunto(s)
Analgésicos Opioides/envenenamiento , Codeína/análogos & derivados , Morfina/envenenamiento , Trastornos Relacionados con Sustancias/mortalidad , Adulto , Codeína/envenenamiento , Resultado Fatal , Femenino , HumanosAsunto(s)
Cerámica , Coronas , Placa Dental , Porcelana Dental , Adulto , Anciano , Índice de Placa Dental , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Índice PeriodontalRESUMEN
A 60-year-old man, who had non-insulin-dependent diabetes but was otherwise in good health, was hospitalized for sudden upper airway obstruction and respiratory arrest. Findings on fiberoptic laryngoscopy were consistent with acute epiglottitis. Blood cultures and factor analysis later revealed that the responsible pathogen was Hemophilus parainfluenzae. Acute epiglottitis in the adult is no longer considered rare and is usually attributed to H influenzae. The case described here and two other cases reported elsewhere indicate that H parainfluenzae may also be a cause of this serious and often fatal infection of the upper respiratory tract.