Forensic Evaluation of Sudden Death Due to Tuberculosis

Abstract

The emergence of drug-resistant tuberculosis (TB) poses a major threat to TB control efforts. We report a case of a 50-year-old man with pulmonary TB. The scene investigation had initially suspected for homicide; however, the result of medico-legal autopsy demonstrated natural cause of death. Statistical data suggest that the rates of national mortality by respiratory TB decreased in the last decades in Hungary; however, an increasing TB mortality was detected in the capital Budapest. Facing a new mortality trend in TB, the forensic scene investigation and determination of manner of death represent new challenges for practitioners.

Sudden death caused by pulmonary fat embolism in a patient with miliary tuberculosis

“…Pulmonary hemorrhage and consequent hemoptysis are the most dramatic clinical presentations in pulmonary TB 21. Even though a pulmonary lesion is small and localized, hemorrhage can cause SD by hypovolemic shock after profuse bleeding, or by asphyxiation due to hemoaspiration 18 , 21 , 22. Even a small amount of blood can obstruct the airway.…”

“…International travel and migration may increase the incidence of TB in industrialized countries. The presence of people with TB—especially with far-advanced active caseating and cavitating pulmonary TB—constitutes a public health hazard 13 , 18. Therefore, prompt and proper diagnosis is important when patients suffer from or die from TB 67 , 68.…”

“…Therefore, prompt and proper diagnosis is important when patients suffer from or die from TB 67 , 68. Especially, in the case of TBRSD, the precise diagnosis is essential through postmortem examination 18 - 20 , 34 , 36. From the viewpoint of both clinical practice and public health, the accumulation of relevant cases and the analyses of pathophysiology are necessary for a greater understanding of TBRSD.…”