Document Detail


Postmortem serum endotoxin level in relation to the causes of death.
MedLine Citation:
PMID:  15708333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Serum endotoxin is a clinical marker of sepsis. However, it is vulnerable to bacterial contamination, and the postmortem stability has not been established. In the present study, to evaluate the forensic pathological significance of postmortem endotoxemia in relation to the causes of death, we investigated a series of 111 autopsy cases (postmortem interval<48 h), in part, using bacteriological investigations. Systemic endotoxemia involving both the cardiac and peripheral blood was observed in some specific causes of death, including pneumonia (n=1/3), peritonitis (n=2/5), delayed traumatic death with severe secondary infection (n=7/33), drownings (freshwater, n=3/9; saltwater, n=3/16), fire deaths (n=3/16), and also in protracted deaths under critical medical care (n=2). Most cases of fatal blunt injury (n=4/5) showed sporadic endotoxemia in cardiac or peripheral blood, whereas there was no elevation of serum endotoxin in acute hemorrhagic death from sharp instrument injury (n=6). The bacteriological investigation showed some characteristic profiles in infections and drownings. These observations suggested that, although endotoxin is a vulnerable serum marker to ante and postmortem interference, systemic postmortem endotoxemia involving peripheral blood may be a possible indicator of antemortem bacteremia related to some specific causes of death accompanied by advanced infection or pulmonary alveolar damage in the dying process especially due to drownings and fires.
Authors:
Bao-Li Zhu; Takaki Ishikawa; Tomomi Michiue; Li Quan; Hitoshi Maeda
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Legal medicine (Tokyo, Japan)     Volume:  7     ISSN:  1344-6223     ISO Abbreviation:  Leg Med (Tokyo)     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-14     Completed Date:  2005-07-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100889186     Medline TA:  Leg Med (Tokyo)     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  103-9     Citation Subset:  IM    
Affiliation:
Department of Legal Medicine, Osaka City University Medical School, Abeno, Osaka 545-8585, Japan. baolizhu@med.osaka-cu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Biological Markers / blood
Central Nervous System Stimulants / poisoning
Child
Child, Preschool
Endotoxins / blood*
Female
Fires
Forensic Pathology*
Gram-Negative Bacteria / isolation & purification
Humans
Infant
Infection / blood
Male
Methamphetamine / poisoning
Middle Aged
Myocardial Infarction / blood
Peritonitis / blood
Pneumonia / blood
Poisoning / blood
Postmortem Changes*
Wounds and Injuries / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Central Nervous System Stimulants; 0/Endotoxins; 537-46-2/Methamphetamine

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