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Sudden death from tubercular myocarditis.
Enrico Silingardi1, Francesco Rivasi, Anna L Santunione
1Institute of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy. silingardi.enrico@unimo.it
Journal of Forensic Sciences
|May 16, 2006
Summary
Tuberculous myocarditis, a rare condition, caused sudden death in a healthy woman. Autopsy revealed Mycobacterium tuberculosis DNA in granulomatous lesions, suggesting cardiac arrhythmia as the cause of death.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Tuberculous myocarditis is an infrequent cardiac manifestation of tuberculosis.
- Sudden cardiac death can rarely be attributed to cardiac tuberculosis.
Observation:
- A previously healthy 33-year-old woman experienced sudden death.
- Autopsy revealed myocardial, pulmonary, nodal, hepatic, and splenic granulomatous lesions.
- Histology did not identify acid-fast bacilli, but PCR detected Mycobacterium tuberculosis DNA.
Findings:
- Polymerase chain reaction confirmed Mycobacterium tuberculosis DNA in formalin-fixed, paraffin-embedded myocardial samples.
- The patient was HIV-negative, as confirmed by PCR and ELISA.
- Granulomatous proliferation in the interventricular septum is hypothesized to have caused fatal ventricular arrhythmia.
Implications:
- This case highlights the importance of considering tuberculous myocarditis in unexplained sudden cardiac deaths.
- Molecular techniques like PCR are crucial for diagnosing tuberculous myocarditis when traditional methods fail.
- Early diagnosis and treatment of tuberculous myocarditis may prevent fatal outcomes.