Fatal but clinically undiagnosed tuberculosis

Area of Science:

• Forensic Pathology
• Public Health
• Infectious Diseases

Background:

• Tuberculosis (TB) remains a significant cause of mortality.
• Delayed diagnosis of active TB can lead to preventable deaths.
• Coroner's autopsies play a role in identifying unrecognized causes of death.

Purpose of the Study:

• To report cases of active tuberculosis diagnosed postmortem by coroners.
• To assess the frequency of TB as an unrecognized cause of death.
• To highlight the diagnostic value of coroners' autopsies in TB cases.

Main Methods:

• Retrospective analysis of coroner's autopsy records.
• Inclusion of cases where active tuberculosis was identified for the first time postmortem.
• Data collection over a five-year period (1977-1981) in Birmingham.

Main Results:

• Forty-one cases of active TB were identified via coroner's autopsy.
• These cases represented 0.3% of all postmortem examinations and 31% of TB deaths.
• Many deceased individuals had recent contact with general practitioners without diagnosis.

Conclusions:

• Coroner's autopsies are crucial for identifying missed TB diagnoses.
• Early recognition and treatment of TB could prevent fatalities.
• Autopsy findings underscore the importance of considering TB in differential diagnoses.