Format

Send to

Choose Destination
Forensic Sci Med Pathol. 2017 Dec;13(4):454-458. doi: 10.1007/s12024-017-9920-3. Epub 2017 Oct 11.

A case of fatal perimyocarditis due to a rare disease.

Author information

1
Institute of Legal Medicine, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany. plenzig@med.uni-frankfurt.de.
2
Institute of Legal Medicine, University Hospital Frankfurt, Kennedyallee 104, 60596, Frankfurt am Main, Germany.

Abstract

Although myocarditis is caused by viral infections in about 50% of cases in European countries, various other causative agents are known. We report the case of a 51-year-old man who died several months after being diagnosed with asthma by his general practitioner. This diagnosis had been confirmed by a pulmonologist approximately 6 weeks before the man's death. To rule out the possibility of medical malpractice the prosecuting authority ordered a forensic autopsy. At autopsy macroscopic indicators for perimyocarditis and pneumonia were found. Microbiological and histological examination of tissue samples confirmed a diagnosis of Churg-Strauss syndrome, also known as Eosinophilic Granulomatosis with Polyangiitis (EGPA). The cause of death was determined to be cardiac involvement in Churg-Strauss syndrome. The presence of this disease also accounted for the man's recent medical history. There were no findings to indicate that a medical error had been made. The reported case illustrates why accessory histological and microbiological examinations should always be performed when macroscopic findings at autopsy suggest myocarditis. Determining the etiology of myocarditis is a necessary step to prevent overlooking rare diseases with inflammatory myocardial involvement, especially in the clarification of alleged medical malpractice.

KEYWORDS:

Churg-Strauss syndrome; EGPA; Medical malpractice assessment; Myocarditis; Rare disease

PMID:
29022232
DOI:
10.1007/s12024-017-9920-3
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center