An autopsy case of sudden unexplained death caused by malaria.
ABSTRACT Sudden unexplained deaths, especially those unwitnessed can lead to forensic issues and would necessitate the need for a meticulous and complete postmortem examination including ancillary investigations to discover the cause of death. We herein report a case of sudden unexplained death caused by malaria in an apparently healthy individual. This fatal case is presented to remind the forensic pathologist of the possibility of malaria as a cause of sudden unexplained death in malaria-endemic regions. In the present case, histopathological examination demonstrated the presence of parasitized red blood cells with malarial pigment in the blood capillaries in the brain, myocardium, pericardium, lungs, kidneys, liver, and the spleen. Cerebral malaria with acute renal insufficiency or pulmonary edema with an acute respiratory distress syndrome might have been the cause of death.
SourceAvailable from: Katia Jaton
Article: Post-mortem diagnosis of malaria09/2014; 2(5). DOI:10.1002/nmi2.52
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ABSTRACT: Unnatural deaths in women of reproductive age (range 12-49 years) have a serious psychological and social impact on the family and community. Deaths among women of reproductive age reported as medico-legal cases were investigated to see the trend in terms of cause and manner of death. The study group consisted of a series of 328 consecutive forensic autopsies on women in the reproductive age group, performed between 2009 and 2011 at the Government Wenlock District Hospital, Mangalore, India by qualified specialist forensic medicine experts. Unnatural deaths formed 93.6% of the cohort. The top three causes of death included burns, poisoning and hanging forming 69.5% of the cases. The manner of death was suicide in 45.4% cases, accident in 43.6% cases and homicide in 4.6% cases. The circumstances of death were related to alleged medical negligence in 2.4% cases. Death in 4% cases was natural mannered with a disease being the cause of death. Three-fourths of the victims were married. Married women formed 63.1% of the suicidal victims. Homicidal deaths were not reported among unmarried women. The preponderant method of suicide was by poisoning at 42.3% (63 cases), followed by hanging (34.9%), burns (11.4%) and drowning (9.4%). These four methods comprised 98% of the total suicidal deaths in this study cohort. Accidental deaths were predominantly caused by burns (62.2%) and road traffic accident (23.1%). Two-thirds of the homicidal deaths were due to assault caused by blunt-force trauma, ligature strangulation and sharp-force trauma. One-third of the homicidal victims died due to burns. With a clear understanding of the cause and manner of death, it may be possible to predict, and hopefully prevent, future cases of unnatural deaths in women of reproductive age who form a very important group of society.Journal of Forensic and Legal Medicine 08/2013; 20(6):651-4. DOI:10.1016/j.jflm.2013.03.029 · 0.99 Impact Factor
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ABSTRACT: This study was designed to study the patient characteristics, presenting features and complications of malaria in patients with elevated liver enzymes and to compare these data to those of patients with normal liver enzymes. A convenient sample of 100 patients with malaria was selected from three tertiary care referral hospitals. Study subjects were divided into two groups: (1) patients (controls) with normal liver enzymes and (2) patients (cases) with >3 times the normal liver enzymes in the absence of an alternate explanation for such elevation. Patient characteristics, presenting features and complications of malaria in these two groups were studied. Data were collected using a semi-structured pretested proforma and were analyzed using the statistical analysis program SPSS, version 11.5 (SPSS, Inc., Chicago, IL). The mean ages were 38.12 years for the cases and 35.20 years for the controls with a non-significant p value of 0.289. Males composed 82% of the cases that were diagnosed with malarial hepatopathy; the remaining 18% were females. Falciparum malaria was present in 56% of the cases, compared to 12% of the controls. Icterus was present in 66% of cases of malarial hepatopathy, compared to 32% of the controls. Of the 66% of these cases, 18.18% had serum bilirubin >3mg%, whereas out of the 32% of the controls presenting with icterus, only 5.55% had serum bilirubin >3mg% (p=0.003). Of the cases with malarial hepatopathy, 38% suffered from hypoglycemia, compared to 0% of the controls (p<0.001); 84% of the cases presented with thrombocytopenia, compared to 70% of the controls (p<0.001); 12% of the cases suffered from renal failure with serum creatinine levels >2mg%, compared to 2% of the controls (p=0.060). Plasmodium falciparum infection (either alone or along with P. vivax) is the leading cause of malarial hepatopathy. Jaundice is a common clinical manifestation among these patients. Patients with malarial hepatopathy have increased incidences of hypoglycemia and thrombocytopenia. Malarial hepatopathy occurs in relation to severe infection, most of which are treated with parenteral artesunate.07/2013; DOI:10.1016/j.jiph.2013.04.003