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Updated: Sep 17, 2025

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

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Stillbirth with a false-positive lung float test result - an unusual case report.

E Hoffmann¹, L Malolepszy², C Hochscheid²

¹Institute of Legal Medicine, Justus-Liebig-University Gießen University Hospital Gießen & Marburg GmbH, Frankfurter Str. 58, D-35392, Gießen, Germany. elmar.hoffmann@uk-gm.de.

Forensic Science, Medicine, and Pathology

|July 2, 2025

Summary

Forensic analysis revealed Fusobacterium gonidiaformans caused false-positive results in the lung float test for a stillborn infant. This finding is crucial for accurate determination of live birth in forensic pathology.

Keywords:

Fusobacterium gonidiaformans Gastrointestinal float sample Lung float sample Stillbirth

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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

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Last Updated: Sep 17, 2025

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus

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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn

Published on: April 7, 2023

Area of Science:

Forensic pathology
Microbiology
Neonatal death investigation

Background:

Determining live birth is critical in forensic investigations of infant deaths.
The lung float test is a common method, but can be confounded by gas-producing bacteria.
Previous cases of bacterial contamination mimicking live birth have been reported.

Purpose of the Study:

To investigate a case of a newborn found lifeless where initial tests suggested live birth.
To identify the etiological agent responsible for misleading forensic test results.
To highlight the importance of microbiological examination in forensic casework.

Main Methods:

Autopsy and histological examination of lung and gastrointestinal tissues.
Performance of the lung float test and gastrointestinal tract float test.
Microbiological culture and identification of microorganisms from lung tissue and heart blood.

Main Results:

The lung and gastrointestinal tract float tests yielded positive results, initially indicating live birth.
Microbiological examination identified Fusobacterium gonidiaformans in lung tissue and heart blood.
Fusobacterium gonidiaformans, an obligate anaerobic gas-forming bacterium, was determined to be the cause of the false-positive float test results.

Conclusions:

The presence of Fusobacterium gonidiaformans can lead to false-positive lung float test results, mimicking live birth.
Microbiological analysis is essential to confirm or refute the findings of the lung float test in forensic investigations.
This case underscores the need for comprehensive testing in determining the viability of a newborn at the time of death.