American Journal of Forensic Medicine and Pathology最新文献_第5页

A Death From Necrotizing Wound Infection After Cesarean Section: Resurgence of Group A Streptococcal Puerperal Sepsis.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-24 DOI: 10.1097/PAF.0000000000001021

Timothy Ogburn, Laura D Knight

{"title":"A Death From Necrotizing Wound Infection After Cesarean Section: Resurgence of Group A Streptococcal Puerperal Sepsis.","authors":"Timothy Ogburn, Laura D Knight","doi":"10.1097/PAF.0000000000001021","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001021","url":null,"abstract":"Abstract: Necrotizing wound infections are potentially lethal complications of surgeries, including cesarean deliveries. A 32-year-old female with obesity and hidradenitis suppurativa (HS) underwent uncomplicated cesarean section. Four days later, she developed abdominal pain and imaging showed ascites; she was treated with antibiotics. She progressed to septic shock and expired the following day from cardiopulmonary arrest. Hospital blood cultures grew no microorganisms. Autopsy revealed soft tissue purulence around the incision and copious purulent ascites without evidence of tubo-ovarian abscess, retained products of conception, or emboli. Microscopic examination of the tissues demonstrated inflammatory debris with neutrophils and gram-positive cocciform bacteria. Postmortem bacterial cultures had no growth. Paraffin blocks submitted to the Centers for Disease Control Infectious Disease Pathology Branch revealed Streptococcus pyogenes. Historically, group A streptococcus (GAS) was a major cause of peripartum mortality, and the prevalence of puerperal sepsis-associated deaths declined with antibiotic usage. Although the rates of mortality have remained stable in the United States, GAS has made a resurgence over recent decades. Additionally, there is some evidence in the literature of cutaneous bacterial biofilms associated with HS. Theoretically, this could have increased the risk of perioperative infection due to colonization or secondary infection of HS lesions.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intrauterine and Neonatal Deaths: The 2013-2023 Experience of the Cuyahoga County Medical Examiner's Office.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-24 DOI: 10.1097/PAF.0000000000001020

Zachary A Wilkinson, Kaitlin Weaver, Thomas Gilson, Alison Krywanczyk

{"title":"Intrauterine and Neonatal Deaths: The 2013-2023 Experience of the Cuyahoga County Medical Examiner's Office.","authors":"Zachary A Wilkinson, Kaitlin Weaver, Thomas Gilson, Alison Krywanczyk","doi":"10.1097/PAF.0000000000001020","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001020","url":null,"abstract":"Abstract: Forensic investigation of intrauterine and perinatal deaths can be challenging, given their relative infrequency and the possible involvement of maternal substance use, trauma, and socioeconomic factors. Intrauterine and perinatal deaths investigated by the Cuyahoga County Medical Examiner's Officer between 2013-2023 were reviewed. One hundred twenty-eight cases were identified (83 stillborn and 45 live births). The predominant indications for referral were concern for maternal substance use (57.8%) or trauma (35.2%). Gestational ages ranged from 11.5 to 42.5 weeks; 36.7% were <22 weeks, and only 10.2% were full term (>37 weeks). The maternal age range was 16-41 years, with most (65.2%) between 20-34 years. Not all case files included obstetric history or home address; of those which did, 53.0% received no prenatal care and 81.7% came from zip codes in the bottom quartile of household incomes. Causes of death included acute and/or chronic maternal substance use (28.9%), chorioamnionitis (21.9%), and abruption (19.5%). Manners of death (when applicable) included natural (53.3%), accident (26.7%), homicide (8.9%), and undetermined/unassigned (11.1%). Potentially confounding socioeconomic factors were identified in most cases. This demonstrates the importance of considering these factors and exercising caution when assigning specific causes and manners to intrauterine and perinatal deaths.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Streptococcal Meningitis Associated With Cerebello-Pontine Angle Meningioma.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-24 DOI: 10.1097/PAF.0000000000001022

Sabrina Gribble, Walter L Kemp

引用次数: 0

Kounis Syndrome Following a Wasp Sting.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-22 DOI: 10.1097/PAF.0000000000001013

Ryan Blumenthal, Paula Troskie, Seduma Suzan Mabotja

引用次数: 0

AJFMP 2024 Reviewer Thank You.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-22 DOI: 10.1097/PAF.0000000000001023

引用次数: 0

Fatal Ludwig Angina in the Setting of Alcohol Withdrawal: A Rare Cause of Death With Postmortem Computed Tomography and Autopsy Correlation. 酒精戒断后致死性路德维希型心绞痛：一种罕见的死因，与死后计算机断层扫描和尸检相关。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-21 DOI: 10.1097/PAF.0000000000001015

Miranda Hanson, Alistair Soon, Alex Forrest, Jessica Vidler, Nathan Milne, Jack Garland

引用次数: 0

Homemade Fentanyl Suicide Machine Used in Experiment to Prove Existence of the Multiverse: A Case Report. 自制芬太尼自杀机用于证明多元宇宙存在的实验：一个案例报告。

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-20 DOI: 10.1097/PAF.0000000000001016

John-Luke Rivera, Claire Sorensen, Lorenzo Gitto

{"title":"Homemade Fentanyl Suicide Machine Used in Experiment to Prove Existence of the Multiverse: A Case Report.","authors":"John-Luke Rivera, Claire Sorensen, Lorenzo Gitto","doi":"10.1097/PAF.0000000000001016","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001016","url":null,"abstract":"Abstract: Deaths by homemade suicide machines naturally capture public attention given the sensationalism of the subject matter and the complexity of the mechanisms involved. In this case, a self-made apparatus designed to administer a fatal dose of fentanyl, leading to an intentional acute toxicity, was used. As detailed in his 19-page manifesto discovered posthumously, the decedent engineered this device with the express purpose of testing the Many-Worlds Interpretation of quantum mechanics. This interpretation posits that for every time one outcome is observed, there are \"parallel universes\" in which a different outcome becomes reality; these \"parallel universes\" are collectively called the \"multiverse.\" By programming his homemade device to kill the versions of himself in the \"parallel universes\" where he did not achieve a desired outcome-that is, having the winning numbers of a Powerball lottery drawing-the decedent sought to experience a reality where he did win the lottery, which would somehow through his convoluted logic thereby prove the existence of the \"multiverse.\"Initially, the bizarre details of the scene led investigators to consider possibilities like intentional electrocution or even homicide executed by remote means. Thorough death scene and background investigation was critical to determine that it was an elaborate act of suicide.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An Autopsy Case of Polymicrobial Cardiac Abscesses With Cultured Klebsiella pneumonaie in the Setting of Hyperosmolar Hyperglycemic State.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-06 DOI: 10.1097/PAF.0000000000001011

Thomas Auen, Erin Linde

引用次数: 0

An Unusual Death From Penetrating Cranial Trauma: The Importance of Investigating the Primary Scene of Injury.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-06 DOI: 10.1097/PAF.0000000000001012

Kelli Oxborrow, Laura D Knight

{"title":"An Unusual Death From Penetrating Cranial Trauma: The Importance of Investigating the Primary Scene of Injury.","authors":"Kelli Oxborrow, Laura D Knight","doi":"10.1097/PAF.0000000000001012","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001012","url":null,"abstract":"Abstract: A 65-year-old man with a history of hypertension and coronary artery disease was found dead at home after having fallen about 6 days prior. Autopsy examination revealed unexplained penetrating trauma of the skull with a circular defect in the frontal bone with associated cerebral laceration and organizing subdural hemorrhage. As the cause of the penetrating injury was unknown, the forensic pathologist instigated further investigation. Through interviews, the medicolegal death investigator identified the primary scene of injury, which was different from the scene of death; she elucidated the injury scenario, including the culprit object, which she photographed during the follow-up investigation. The etiology of the injury allowed the medical examiner to correctly certify manner of death. This case represents an interesting example of penetrating cranial injury, with minimal external injury and extensive internal lethal damage to the brain. Furthermore, it highlights the importance of investigating the primary scene of injury, especially when death is delayed and the deceased is no longer at the injury location.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Brain Findings in Deceased COVID-19 Patients.

IF 1 4区医学

American Journal of Forensic Medicine and Pathology Pub Date : 2025-01-06 DOI: 10.1097/PAF.0000000000001010

Armaan Shergill, Bennet Omalu, Peter Conner, Machelle Wilson

{"title":"Brain Findings in Deceased COVID-19 Patients.","authors":"Armaan Shergill, Bennet Omalu, Peter Conner, Machelle Wilson","doi":"10.1097/PAF.0000000000001010","DOIUrl":"https://doi.org/10.1097/PAF.0000000000001010","url":null,"abstract":"Abstract: As COVID-19 continues to infect millions of people globally, it is essential to understand how SARS-CoV-2 affects the brain. The purpose of this study is to determine if there are any associations or patterns of gross and microscopic neuropathological autopsy findings in the brains of patients who died from COVID-19. We analyzed 32 autopsy cases that met 3 requirements: (1) positive polymerase chain reaction (PCR) SARS-CoV-2 test at autopsy; (2) pulmonary histological features of SARS-CoV-2; (3) complete autopsies conducted during the COVID-19 pandemic from 2020 to 2023. We accounted for the presence of the following gross and microscopic neuropathological findings: cerebral edema (CE), cerebral cortical atrophy (CCA), chronic cerebrovascular disease (CCD), cerebral ischemic injury (CII), cerebral inflammation (CIN), and/or cerebral parenchymal hemorrhage (CPH) in every case. We found that CE, CCA, and CII diagnoses had a statistically significant association with age. There were no distinctive or recurrent neuropathological alterations in the autopsied brains that may be interpreted to be pathognomonic of SARS-CoV-2 infection in our cohort. These findings may suggest that SARS-CoV-2 infection is not associated with any distinct histomorphologic abnormalities that are diagnostic of COVID-19 in the brains of autopsied patients.","PeriodicalId":55535,"journal":{"name":"American Journal of Forensic Medicine and Pathology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0