Late‐onset miliary pneumonitis after near drowning

Mangge, Harald; Plecko, Barbara; Grubbauer, H. M.; Popper, Helmut; Smolle‐Jüttner, Freyja‐Maria; Zach, M

doi:10.1002/ppul.1950150210

Cited by 13 publications

(4 citation statements)

References 8 publications

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“…The consequences of aspiration depend on many factors, such as the quantity, size and solidity of the material aspirated and whether the aspiration is chronically recurrent or acute [15]. The only similar representative description with pollen grains related in a death explanation was a posterior granulomatous lung inflammation after finding affected tissular lung areas or pneumonitis due to foreign bodies reaction from a water aspiration of microalgae and pollen grains (near-drowning event) [15]. In our present study, however, due to the long PMI, no histopathologic information could be considered to address a conclusion of asphystic death.…”

Section: Resultsmentioning

confidence: 99%

Pollen Findings in a Presumptive Drowning Case

Martínez¹,

González-Porto²,

Munuera³

et al. 2015

FMAR

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A medicolegal/botanical collaboration has to lead to an interdisciplinary procedure for developing methods when studying dead bodies found in water with no clear circumstances. Hereby we present a report or a preliminary attempt as a basis for encouraging further work in the field. The body of an unidentified 25-35 years old woman was found immersed in a fresh water ditch in state of decomposition. Structural alterations avoid any a priori identification of asphyxia or traumatic cervical lesions. The last cause of death was estimated as a cardio respiratory collapse and a drowning investigation was proposed. Taxonomic species identification was carried out to relate the pollen aspiration with the water medium in lung, spleen, liver and water medium. We presented pollen grains in spleen, as a closed organ, as a clue for death investigation in the absence of diatom findings. Information about where and when pollen grains occur may ascertain that a body or an object was in some place at a certain time. Since the consequences of aspiration depend on many factors, such as the quantity, size and solidity of the material aspirated and whether the aspiration is chronically recurrent or acute, the pollen investigation must be done with precaution. We conclude that in the absence of other microscopic structures, biochemical blood analyses, or histological findings, forensic palynology may be of help to relate the presumptive drowned body with its death scenario.

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Section: Resultsmentioning

confidence: 99%

Pollen Findings in a Presumptive Drowning Case

Martínez¹,

González-Porto²,

Munuera³

et al. 2015

FMAR

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“…Interestingly, animal studies have demonstrated granuloma formation is possible through the subcutaneous introduction of diatomite dust 12 . Furthermore, Mangge et al highlight a case of late‐onset miliary pneumonitis where, upon histologic examination, granulomatous inflammation with dispersed diatoms was noted in a lung biopsy of a 7‐year‐old boy 5 weeks after a near drowning incident 13 . It is likely that the antigenicity of diatoms resides in their protoplasm, while their granulomatous‐evoking properties are attributed to the inert amorphous silica shell.…”

Section: Discussionmentioning

confidence: 99%

A case of oral foreign‐body granuloma due to diatoms

et al. 2020

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Diatoms are photosynthetic algae with a siliceous exoskeleton. Diatoms are utilized by a wide array of industries for applications such as filtration and pest control. Unsubstantiated claims have also propelled their societal reach to trendy oral and topical uses. This case highlights a rare case of an oral granuloma secondary to diatoms. An 80‐year‐old woman presented with a mobile, firm, asymptomatic submucosal mass on her lower left mandibular vestibular mucosa. Histopathology showed a non‐caseating granulomatous reaction to diatoms. Her only verified contact with a diatomaceous earth product was a dental impression using alginate after upper front teeth trauma 5 months before. Although there have been several cases of allergic contact dermatitis attributed to diatoms, there are no reported cases of diatom‐induced granuloma formation found in the literature. There are, however, ample data on granulomas initiated by silica. Given the silica‐based composition of diatoms, and the broad use of diatoms in industry and alternative medicine, it is unclear why diatom‐induced granulomas are not more widely described. This report may alert clinicians to the existence of diatom granulomas and incline them to tailor their history to cover questions about possible exposure when evaluating patients presenting with a localized oral lesion.

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“…Pneumonia may at times be due to uncommon pathogens (Cavens et al 1973;Baethge et al 1990), and can be accompanied with the formation of multiple lung abscesses. Dirt or shallow water aspiration can lead to diffuse pneumonitis (Mangge et al 1993;Li et al 2009). …”

Section: Complicationsmentioning

confidence: 98%