Waterhouse Friderichsen Syndrome: Medico-legal issues

Mascolo, Pasquale; Feola, Alessandro; Zangani, Pierluca; Famularo, Davide; Liguori, Bruno; Mansueto, Gelsomina; Campobasso, Carlo Pietro

doi:10.1016/j.fsir.2021.100235

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…For example, adrenal hemorrhages, which have been described to occur in wild boar upon experimental infection (29), were examined in more histopathological detail and revealed interesting results in the present study. Our findings mirror a condition known as Waterhouse Friderichsen syndrome (31). It has been correlated with several bacterial and viral diseases and is characterized by severe hemorrhage, necrosis and microvascular thrombosis.…”

Section: Discussionsupporting

confidence: 82%

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Pathology of African Swine Fever in wild boar naturally infected with German virus variants

Sehl-Ewert

Deutschmann

Breithaupt

et al. 2022

Preprint

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In 2020, African swine fever (ASF) was first notified in German wild boar, reaching a case number of about 4200 to date. Upon experimental infection, pathology is well-documented, however, data on field infections are very scarce in domestic pigs and not available from wild boar, respectively. Although ASF viral genome is considered exceptionally stable, a total of five lineages with 10 distinct virus variants of genotype II have emerged in Eastern Germany. To investigate the pathology in naturally infected wild boar and to evaluate virus variants II, III and IV for their virulence, wild boar carcasses were obtained from three different outbreak areas. The cadavers underwent virological and pathomorphological investigation. Regardless of the virus variant all wild boar revealed characteristic lesions of highest severity indicative for ASF. However, wild boar infected with variant IV from Spree-Neiße (SN) district showed lower viral genome loads and a lower total viral antigen score, but simultaneously revealed more chronic lesions. Our findings indicate a protracted course of the disease at least after infection with variant IV, but need confirmation under standardized experimental conditions. There is a strong need to monitor differences in the virulence among variants to identify potential attenuation that might complicate diagnosis.

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Section: Discussionsupporting

confidence: 82%

“…Friderichsen syndrome (31). It has been correlated with several bacterial and viral diseases and is characterized by severe hemorrhage, necrosis and microvascular thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Pathology of African Swine Fever in wild boar naturally infected with German virus variants

Sehl-Ewert

Deutschmann

Breithaupt

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…In fact, one report has already described a case in which the family of the patient suspected medical malpractice due to delayed clinical diagnosis in a WFS autopsy case for a patient that died about an hour after the sudden change (Mascolo et al 2021).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Three Autopsy Cases of Non-Meningococcal Waterhouse-Friderichsen Syndrome with Hypoplastic Spleen or Post-Splenectomy Status

Horita

Kosaka

Takaoka

et al. 2022

Tohoku J. Exp. Med.

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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. 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 S. 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.

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Useful Evidence by Post-Mortem CT and Stereomicroscopy in Bone Injury: A Case Series from Forensic Practice

et al. 2023

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The investigation of bone injuries is an essential topic in forensics. We sometimes have to deal with charred or dismembered human remains that have lost soft tissue, making it difficult to diagnose the mechanisms of injury that led to death. Our contribution aims to share with the scientific community how we approached two cases of very different bone injuries and the techniques used to differentiate relevant pathology findings of bone fragments. Two cases are analyzed from the case history of the forensic medicine institute of Palermo. PMCT made it possible to differentiate heat bone lesions from traumatic lesions. The stereomicroscope was superior to PMCT in being able to better characterize and evaluate shear injuries, allowing a more accurate measurement of acute lesions. Injury to bone remains can be appropriately investigated with rapid techniques such as PMCT and stereomicroscopy. The presented methodology shows the importance of a multidisciplinary approach when dealing with bone injuries in forensics that could find further applications in other circumstances to answer forensic questions.

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Waterhouse Friderichsen Syndrome: Medico-legal issues

Cited by 4 publications

References 30 publications

Pathology of African Swine Fever in wild boar naturally infected with German virus variants

Pathology of African Swine Fever in wild boar naturally infected with German virus variants

Three Autopsy Cases of Non-Meningococcal Waterhouse-Friderichsen Syndrome with Hypoplastic Spleen or Post-Splenectomy Status

Useful Evidence by Post-Mortem CT and Stereomicroscopy in Bone Injury: A Case Series from Forensic Practice

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