神戸大学附属図書館デジタルアーカイブ
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https://hdl.handle.net/20.500.14094/90005752
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2024-04-20
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90005752 (fulltext)
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メタデータID
90005752
アクセス権
open access
出版タイプ
Version of Record
タイトル
Autopsy case of acute pulmonary thromboembolism with neurosyphilis
著者
Kondo, Takeshi ; Takahashi, Motonori ; Kuse, Azumi ; Morichika, Mai ; Nakagawa, Kanako ; Sakurada, Makoto ; Asano, Migiwa ; Ueno, Yasuhiro
著者ID
A0777
研究者ID
1000020335441
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=593f65aa19bbda3a520e17560c007669
著者名
Kondo, Takeshi
近藤, 武史
コンドウ, タケシ
所属機関名
医学研究科
著者ID
A0818
研究者ID
1000090509100
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=4564f4b4306b3f9f520e17560c007669
著者名
Takahashi, Motonori
高橋, 玄倫
タカハシ, モトノリ
所属機関名
医学研究科
著者名
Kuse, Azumi
著者名
Morichika, Mai
著者名
Nakagawa, Kanako
著者名
Sakurada, Makoto
著者名
Asano, Migiwa
著者ID
A0755
研究者ID
1000030184956
KUID
https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=eafde612906c041f520e17560c007669
著者名
Ueno, Yasuhiro
上野, 易弘
ウエノ, ヤスヒロ
所属機関名
医学研究科
収録物名
Egyptian Journal of Forensic Sciences
巻(号)
8
ページ
47-47
出版者
SpringerOpen
刊行日
2018-12
公開日
2019-03-27
抄録
Background: Syphilis is caused by the bacterium Treponema pallidum. Syphilis is a multistage disease, and the clinical stages of syphilis are divided to primary, secondary, and tertiary syphilis, where the tertiary stage is classified as neurosyphilis, cardiovascular syphilis, or gummatous syphilis. Here, we describe an autopsy case of acute pulmonary thromboembolism with neurosyphilis. Case presentation: A male in his early 40s began to complain of hallucinations. He was admitted to a psychiatric hospital as an emergency case 4 days before death. He was physically restrained to control agitation and aggressiveness. The patient was severely obese (BMI 36.45). At autopsy, large thromboembolic masses filled the pulmonary trunk and both pulmonary arteries. Thrombi were also noted in the right popliteal vein and bilateral gastrocnemius and soleus veins, suggesting bilateral lower extremity deep vein thrombosis. Dissection of the brain, which weighed 1457 g, revealed no noteworthy macroscopic findings. Histological examination showed lymphocyte infiltration into the perivascular space of the brain tissue with no vasculitis. Immunohistochemical staining of T. pallidum was negative, the fluorescent treponemal antibody-absorption test was positive, the rapid plasma reagin titer was 1:4, and the T. pallidum hemagglutination assay titer was 1:10,240. Real-time PCR assay of the brain tissue detected low copy numbers of T. pallidum genes. Altogether, the cause of death was acute pulmonary thromboembolism resulting from bilateral lower extremity deep vein thrombosis. The patient also had early-stage meningovascular neurosyphilis. Conclusion: An autopsy case of acute pulmonary thromboembolism with meningovascular neurosyphilis is presented, including histopathological examination, serological assessment, and genetic testing. Forensic pathologists should pay attention to a myriad of syphilitic manifestations. The contributing factors for thrombosis in the present case included severe obesity, probable dehydration, and physical restraints implemented to control meningovascular neurosyphilis-induced neuropsychiatric symptoms.
キーワード
Neurosyphilis
Pulmonary thromboembolism
Physical restraint
Meningovascular
Forensic pathology
カテゴリ
医学研究科
学術雑誌論文
権利
© The Author(s) 2018.
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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資源タイプ
journal article
言語
English (英語)
ISSN
2090-536X
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eISSN
2090-5939
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関連情報
DOI
https://doi.org/10.1186/s41935-018-0080-8
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