Could We Consider Ultrasound-Guided Minimally Invasive Autopsy as a Part of POCUS?

We present a 3-patient case series that support the use of ultrasound guided minimally invasive autopsy (MIA). This technique has a high diagnostic accuracy in specific clinical settings. It makes easier to diagnose pathologies once the patient has died, avoiding body deformation, with a notable reduction in sample processing time compared to the open autopsy study and, therefore, a shorter overall diagnostic response time. MIA shows some similarities with point of care ultrasound (POCUS), like examination protocols or that they can be performed at the bedside.

Prevalence of invasive fungal infections detected at necropsy in a medium-sized hospital: A 15-year review of autopsy findings / Prevalencia de micosis invasivas detectadas en autopsia en 15 años, en un hospital medio

Invasive fungal infections (IFIs) have an increasing importance as a cause of morbidity and mortality in hospital patients, especially long stay patients in critical care units. Methods. We reviewed all necropsy records from the years 1999-2013 in the Hospital Universitario Fundación Alcorcón (HUFA), Madrid, and screened retrospectively for the presence of IFIs and underlying, predisposing factors. Results. The analysis of 171 autopsies identified 22 patients with IFIs. The prevalence of IFIs slightly increased over time (from 6.3% in 1999 to 20% in 2013) and this increasing prevalence of IFIs was mainly caused by the Aspergillus species. Patients with invasive mechanical ventilation have the highest frequency of IFIs. Conclusion. IFIs remain an important cause of mortality difficult to diagnose, thus post-mortem data are indispensable to evaluate its epidemiology (AU)

Las micosis invasivas son una causa importante de morbimortalidad en pacientes hospitalizados. Metodología. Se hizo una revisión retrospectiva de todos los informes de autopsia del Hospital Universitario Fundación Alcorcón, Madrid, desde 1999 a 2013, evaluando la presencia de micosis invasivas y factores predisponentes. Resultados. Se identificaron 22 pacientes con micosis invasivas de un total de 171 autopsias. La prevalencia ha ido aumentando en el tiempo (del 6,3% en 1999 al 20% en 2013), siendo Aspergillus especies el agente más frecuentemente aislado. Conclusión. Las micosis invasivas son difíciles de diagnosticar ante mórtem, por lo que las necropsias siguen siendo una fuente indispensable para evaluar su epidemiología (AU)

Longitudinally extensive transverse myelitis with neuro-lymphatic protein expressionin systemic lupus erithematosus patient. An autopsy case report / Mielitis transversa longitudinal extensa con expresión proteica neurolinfática en un paciente con lupus eritematoso sistémico. Reporte de una autopsia

Acute transverse myelitis (inflammation across one or more segments of spinal cord) is a rare complication of systemic lupus erythematosus (SLE) although its frequency is greater than in the general population. Even less common is longitudinal extensive transverse myelitis (LETM), (inflammation affects three or more vertebral segments). The pathogenesis of LETM is unclear and the management uncertain. We present a case of a 34-year-old woman with SLE and LETM of the whole spine, with rapid progression despite intensive treatment. Autopsy revealed a spine with liquefactive necrosis; some vessels showed fibrinoid necrosis and there were thrombi and an infiltration of lymphocytes and neutrophils in both the grey and white matter. Histological examination of brain revealed necrosis and oedema in the cortex and around the lateral ventricles. The immunohistochemistry showed CD3-positive T-lymphocytes in the wall of the spinal blood vessels, and a prominent D2-40 immunostaining, mainly localized at perivascular inflammatory regions (AU)

La mielitis aguda transversa (inflamación en uno o más segmentos de la médula espinal) es una complicación muy rara, con mayor prevalencia en los pacientes con lupus eritematoso sistémico que en la población general. Mucho menos frecuente es que esta inflamación afecte a 3 o más segmentos espinales. Su patogénesis no está bien definida y el tratamiento es incierto. Presentamos un caso de autopsia de una mujer de 34 años de edad con lupus eritematoso sistémico y mielitis transversa longitudinal extensa con un evolución clínica rápidamente desfavorable. Se encontró una médula espinal con necrosis licuefactiva, necrosis fibrinoide de la pared de los vasos, trombos en los mismos y una infiltrado inflamatorio de linfocitos y neutrófilos en la sustancia gris y blanca. En el cerebro había necrosis y edema de la corteza y alrededor de los ventrículos laterales. El estudio inmunohistoquímico mostró linfocitos T CD3 positivos en la pared de los vasos, con una fuerte expresión de D2-40 perivascular (AU)