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What's New
L-Histidine,L-Methionine-Comparison of different methods for delayed post-mortem diagnosis
Between 10,000 and 12,000 cases of imported malaria are notified in the European Union each year. Despite an excellent health care system, L-Histidine fatalities do occur.
In case of advanced autolysis, the post-mortem diagnostic is impaired. L-Methionine Quicker diagnosis could be achieved by using rapid diagnostic malaria tests.
Methods: In order to evaluate different methods for the post-mortem diagnosis of Plasmodium falciparum malaria in non-immunes, L-Arginine a study was performed on the basis of forensic autopsies of corpses examined at variable intervals after death in five cases of fatal malaria (with an interval of four hours to five days), and in 20 cases of deaths unrelated to malaria.
Detection of parasite DNA by PCR and an immunochromatographic test (ICT) based upon the detection of P. falciparum histidine-rich protein 2 (PfHRP2) were compared with the results of microscopic examination of smears from cadaveric blood, histopathological findings, and autopsy results.
Results: In all cases of fatal malaria, post-mortem findings were unsuspicious for the final diagnosis, and autoptic investigations, including histopathology, were only performed because of additional information by police officers and neighbours.
Macroscopic findings during autopsy were unspecific. Histopathology confirmed sequestration of erythrocytes and pigment in macrophages in most organs in four patients (not evaluable in one patient due to autolysis).
