International Journal of Legal Medicine

, Volume 122, Issue 1, pp 35–41

Pathology of fatal traumatic and nontraumatic clostridial gas gangrene: a histopathological, immunohistochemical, and ultrastructural study of six autopsy cases

  • Michael Tsokos
  • Sarah Schalinski
  • Friedrich Paulsen
  • Jan P. Sperhake
  • Klaus Püschel
  • Ingo Sobottka
Original Article

Abstract

We prospectively investigated six fatal cases of clostridial gas gangrene using autopsy, histology, immunohistochemistry, microbiology, and scanning electron microscopy. The causative pathogen was Clostridium perfringens in four cases, C. sordellii in one case, and a mixed infection with both C. perfringens and C. sordellii in one case. According to the previous medical history and autopsy findings, clostridial infection was related to trauma in three cases. Characterized by extensive tissue necrosis and total absence of an accompanying leukocyte infiltration and tissue inflammatory response, the histopathological picture of clostridial gas gangrene is distinctly different from other bacterial infections. In medicolegal casework, the proof of the source of infection and the portal of entry of the responsible pathogen is not always an easy task, especially in the absence of trauma.

Keywords

Gas gangrene Clostridial myonecrosis Clostridium perfringens Autopsy Forensic pathology 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Michael Tsokos
    • 1
  • Sarah Schalinski
    • 1
  • Friedrich Paulsen
    • 2
  • Jan P. Sperhake
    • 3
  • Klaus Püschel
    • 3
  • Ingo Sobottka
    • 4
  1. 1.Institute of Legal Medicine and Forensic SciencesCharité—Universitätsmedizin BerlinBerlinGermany
  2. 2.Department of Anatomy and Cell BiologyMartin Luther University of Halle-WittenbergHalle (Saale)Germany
  3. 3.Institute of Legal MedicineUniversity Hospital Hamburg-EppendorfHamburgGermany
  4. 4.Institute of Infectious MedicineUniversity Hospital Hamburg-EppendorfHamburgGermany

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