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Comparative Study of Acute Anogenital Injury Between Consensual and Nonconsensual Postmenarche Adolescents
In Thailand, sexual activity involving those under the legal age of consent may be legally and medically problematic, even if it is consensual. Thus, differentiating anogenital injury characteristics that occur during consensual versus nonconsensual acts with adolescent female subjects could aid legal advocates and improve health care and social support for these patients. Our study included postmenarche female patients having acute anogenital injuries after consensual and nonconsensual penetration. We found that nonconsenting patients had more cases of anogenital injury than consenting (69.8% vs 55.5%), with at least 1 ab...
Source: The American Journal of Forensic Medicine and Pathology - May 18, 2022 Category: Forensic Medicine Tags: Original Articles Source Type: research

Hydatid Disease, an Uncommon Etiology of Death in Forensic Practice
In Tunisia, hydatid cyst is an endemic parasitic disease. The cyst may remain asymptomatic, discovered accidentally, or in case of a complication, the most serious of which is sudden death. We propose, in this article, to analyze the degree of involvement of the cyst in the mechanism of death, through the review of 25 cases. A total of 7932 autopsy cases were performed during the study period. Twenty-five cases of hydatid cyst discovered at autopsy were collected and death was attributed to hydatid cyst in 13 cases. The seat of the cyst was variable and death was due to anaphylaxis in 10 cases, to hydatious embolism in 2 c...
Source: The American Journal of Forensic Medicine and Pathology - May 18, 2022 Category: Forensic Medicine Tags: Original Articles Source Type: research

Investigating the Source of Fatal Pulmonary Thromboembolism in a Coronial Postmortem Population
This study retrospectively examined postmortem examination reports from Australian Coronial investigations of sudden death resulting from pulmonary thromboembolism to determine the likelihood of dissection of the deep veins of calves of the legs revealing the source of a pulmonary thromboembolism. From 450 cases taken from the National Coronial Information System (NCIS) for 2016, the postmortem reports of 327 cases were reviewed to provide demographic details of victims of sudden death from pulmonary thromboembolism. In 235 cases, it was possible to determine in 76.6% a thrombus had been found in the deep veins of the calv...
Source: The American Journal of Forensic Medicine and Pathology - May 18, 2022 Category: Forensic Medicine Tags: Original Articles Source Type: research

Non–Firearm-related Homicides at the Medical University of South Carolina, 2013–2018
After high-profile events involving firearms, gun violence often becomes the center stage of public discourse with national media attention, overshadowing less common causes of homicidal deaths, such as sharp force injury, blunt trauma, and asphyxia. A retrospective analysis of all cases referred for medicolegal autopsy to the Medical and Forensic Autopsy Division of the Department of Pathology and Laboratory Medicine at the Medical University of South Carolina from 2013 to 2018 documented 793 deaths where the manner was classified as homicide. Of these, 18% (144) of the deaths were caused by non–firearm-inflicted injuri...
Source: The American Journal of Forensic Medicine and Pathology - May 18, 2022 Category: Forensic Medicine Tags: Original Articles Source Type: research

Comprehensive Severe Acute Respiratory Syndrome Coronavirus 2 Detection Using Polymerase Chain Reaction and Rapid Antigen Testing in Postmortem Specimens
In this study, we performed comprehensive reverse transcription quantitative PCR (RT-qPCR) and rapid antigen tests for COVID-19 on forensic postmortem specimens, regardless of the antemortem symptoms and causes of death. Immediately before forensic external examination and autopsy, a wiping solution was collected from the nasopharynx with a dry swab, and rapid antigen testing and RT-qPCR were performed. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected by RT-qPCR in 12 of the 487 cases; the infection rate was 2.46%. Of the RT-qPCR–positive cases, 7 were associated with COVID-19–related deaths. C...
Source: The American Journal of Forensic Medicine and Pathology - May 18, 2022 Category: Forensic Medicine Tags: Original Articles Source Type: research

The Public Health Role of Medical Examiner Offices During COVID-19 and Other Mass Fatality Events
The public health role of a medical examiner office (MEO) in a pandemic is largely undefined; however, death data may be useful in strategic planning. Deaths reportable to MEO are defined in statute, with discretion as to the assumption of jurisdiction. We analyzed the daily reported death numbers (DRDNs) in our jurisdiction from March 1, 2020, to March 31, 2021, and compared them with hospital admission and COVID-19 fatality data over the same period. The DRDN from an MEO is easily obtained and may be useful as a supplemental and surrogate metric in certain pandemic mass casualty decisions. Hospital admission data were an...
Source: The American Journal of Forensic Medicine and Pathology - May 18, 2022 Category: Forensic Medicine Tags: Original Articles Source Type: research

Unilateral Thalamic Hemorrhages After Cardiopulmonary Resuscitation
No abstract available (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Illustrated Forensic Pathology Source Type: research

Spontaneous Cerebellar Hemorrhage/Infarct in 34-Year-Old Female
No abstract available (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Illustrated Forensic Pathology Source Type: research

Acute Fibrinous and Organizing Pneumonia—A Rare Lung Pathology
No abstract available (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Illustrated Forensic Pathology Source Type: research

Continued Dangers From Bed Pole Mobility Devices
Bed poles are held in place by a frame that is inserted underneath a bed mattress and are designed to assist in moving an incumbent from a lying to an upright sitting position, or to help with turning, repositioning, or transferring. Two cases demonstrate, however, that lethal entrapment may be caused by such devices—a 76-year-old man and an 84-year-old woman were both found beside their beds hanging by their necks from bed poles. Gaps between bed poles and mattress/bed sides may provide potentially lethal confined spaces. Individuals at particular risk of such an event are elderly with limited strength and/or obesity wi...
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Case Reports Source Type: research

Exsanguination From Superficial Lower Extremity Trauma
This article reports 2 deaths from external hemorrhage arising from superficial lower extremity trauma in persons with peripheral vascular disease and anticoagulant therapy. The first involved a 78-year-old woman who was found unconscious in her home by a relative, with a plastic bag tied around her left foot and evidence of profuse hemorrhage arising from a left great toenail partial avulsion injury. The second involved a 48-year-old male resident of an adult group home who was involved in a physical altercation with a group home employee, who reportedly kicked the decedent in the right shin, resulting in extensive hemorr...
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Case Reports Source Type: research

Coccidioides immitis: A Rare Form of the Disease Process Presenting in an Even Rarer Location
We present the case of a 50-year-old man who was found unresponsive in his home in the northern portion of the United States. Autopsy revealed a 2163-g spleen. The initial differential diagnosis for the splenomegaly was an infection or a neoplastic process, such as leukemia. Because of the geographic location where the body was found, C. immitis was not initially considered; however, microscopic examination confirmed the presence of C. immitis spherules, which were found in the spleen and other organs. Granulomatous inflammation, often associated with spherules, was also present in a kidney, the pancreas, the thyroid gland...
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Case Reports Source Type: research

Fatal Excipients: An Autopsy Case Series of Excipient Lung Disease
We describe 5 patients with excipient lung disease that had antemortem chronic medical conditions that required a peripherally inserted catheter or port. All 5 patients had intravascular and perivascular deposition of polarizable foreign material within the pulmonary arteries. Foreign body granulomatosis as a result of intravenous drug use was not clinically suspected in any patient, and 2 of the 5 patients were misdiagnosed with mycobacterium infections. Pulmonary congestion, dyspnea, and symptoms of heart failure were noted in 3 patients and 2 had a history of upper arm deep vein thrombosis. We conclude that excipient lu...
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Case Reports Source Type: research

Ruptured Splenic Artery Pseudoaneurysm Causing Hemorrhage Into a Pancreatic Pseudocyst
This case report describes fatal exsanguination due to splenic artery hemorrhage into a pancreatic pseudocyst with cystogastrostomy in a 46-year-old woman. The decedent had a complicated medical history including necrotizing pancreatitis, giant pseudocyst formation after cystogastrostomy procedure, and coiling of a hemorrhagic splenic artery. While hospitalized, she underwent embolization of a ruptured splenic artery pseudoaneurysm. Weeks later, she went into hemorrhagic shock and was ultimately pronounced at the hospital. Doctors suspected an upper gastrointestinal (GI) bleed as the cause of death; however, the patient wa...
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Case Reports Source Type: research

Isolated Atrial Neutrophilic Myocarditis: A Rare Cause of Death and Potential “Blind Spot” for Postmortem Computed Tomography and Postmortem Examination
We report a fatal case of isolated neutrophilic atrial myocarditis affecting only the left atrium in a 33-year-old woman presenting as a sudden unexpected death. Microscopy of the left atrium, a not commonly sampled area of the heart, showed florid neutrophilic myocarditis with the remaining right atrium, conduction system, and both ventricles uninvolved. Similar to previously reported fatal isolated atrial lymphocytic myocarditis, postmortem computed tomography was unable to detect any atrial abnormalities. This case highlights a potential “blind spot” for both routine postmortem imaging and examination. (Source: The ...
Source: The American Journal of Forensic Medicine and Pathology - February 4, 2022 Category: Forensic Medicine Tags: Case Reports Source Type: research