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The petrified heart in sepsis.
I Sinicina1, E Matevossian, F Fischer
1Department of Forensic Medicine, Ludwig Maximilians University Munich, Frauenlobstr. 7 a, 80337 Munich, Germany. inga.sinicina@med.uni-muenchen.de
Virchows Archiv : an International Journal of Pathology
|July 14, 2005
Summary
A transsexual man developed severe sepsis and died after injecting urine intravenously. Postmortem revealed extensive heart calcifications, likely due to endotoxin-related myocarditis from sepsis.
Area of Science:
- Cardiology
- Toxicology
- Pathology
Background:
- Accidental intravenous injection of urine is a rare event.
- Severe sepsis can lead to multi-organ dysfunction.
- Myocarditis is inflammation of the heart muscle.
Observation:
- A 33-year-old transsexual man accidentally injected urine intravenously instead of methadone.
- He developed severe sepsis and died 28 days later.
- Postmortem examination revealed extensive cardiac calcifications, primarily in the left ventricle.
Findings:
- Histological examination showed widespread calcification of the heart muscle, sparing the conduction system.
- No calcium deposits were found in other organs.
- The cardiac calcifications were attributed to endotoxin-related myocarditis secondary to severe sepsis.
Implications:
- This case highlights a rare but fatal complication of severe sepsis.
- Early recognition and treatment of sepsis are crucial.
- Urgent heart transplantation may be the only effective treatment for such advanced cardiac calcification.
- Clinicians require awareness of this potential complication for timely diagnosis and management.