| Autor: |
Horita T; Department of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi., Kosaka N; Faculty of Medicine, University of Yamanashi., Takaoka S; Department of Gastroenterology and Hepatology, University of Yamanashi Hospital., Fujii G; Laboratory of Systems Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo., Fujimoto K; Department of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi., Koshimizu Y; Department of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi., Kakuda T; Department of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi., Shojo H; Department of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi., Adachi N; Department of Legal Medicine, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi. |
| Abstrakt: |
We report three cases of Waterhouse-Friderichsen syndrome (WFS) that were confirmed during forensic autopsies. Case 1 involved a man in his 50s post-splenectomy. Bacteriological examination revealed Streptococcus pneumoniae (S. pneumonia). The patient was considered to have died of asphyxiation after aspirating vomit. Case 2 involved a man in his 40s. Bacteriological examination again revealed S. pneumoniae. Histopathological examination showed hypoplasia of the spleen. This patient was considered to have died of multiple-organ failure due to sepsis, disseminated intravascular coagulation, and WFS. Case 3 involved a post-splenectomy woman in her 60s with a history of systemic lupus erythematosus. Bacteriological examination revealed Streptococcus oralis. This patient was considered to have died of multiple-organ failure due to sepsis, disseminated intravascular coagulation, and WFS. These three cases were included among forensic autopsies conducted in the last 5 years. WFS has been considered a rare disease, but may be more frequent than previously assumed. If a mildly ill patient displays a sudden change in status and dies within a short period of time, we consider it necessary to perform not only bacteriological examinations, but also histopathological examination of the spleen during autopsy. |
