An autopsy report of rare purulent pericarditis caused by Streptococcus anginosus infection that spread from the liver abscess

Abstract

Streptococcus anginosus group (SAG) is Gram-positive streptococci and a commensal in the upper airway and gastrointestinal and conceptive swathe. It is a commensal microorganism and not well recognized as a pathogen that causes the disease; moreover, death due to the infection is also rare. However, it can cause invasive infections and induce purulent infection with abscess formation under certain conditions and risk factors. We report a rare case of purulent pericarditis in a male deceased who presented with sudden death. The underlying purulent pericarditis that spread from the liver abscess was identified through autopsy examination. Local spread from adjacent organs is rare. The culprit organism was a commensal that became a pathogen under a certain environment. SAG pyogenic pericarditis is an infrequent but severe and fatal condition. A holistic approach to the case must emphasize autopsy findings in a case where the history is limited, especially in forensic practice. Two crucial processes are required to determine the cause of death: through a thorough autopsy and by understanding causation. To conclude that a death was caused by a commensal pathogen is the most difficult task in forensic pathology, and careful examination of postmortem investigations is essential.