Mechanisms of deaths in captive juvenile New Zealand fur seals (Arctocephalus forsteri)

Juvenile seals are sometimes encountered in waters around South Australia with injuries and/or diseases that require veterinary treatment. Two cases are reported where apparently stable animals died soon after being rescued due to quite disparate conditions. In Case 1 a juvenile male New Zealand fur seal (Arctocephalus forsteri) was found unexpectedly dead in its enclosure. A necropsy examination revealed an emaciated juvenile male with no injuries. The intestine was filled throughout its length with melena stool that was due to heavy infestation of the stomach with roundworms with adjacent gastritis. Death was due to shock from upper gastrointestinal blood loss secondary to parasitosis. In Case 2 a second juvenile male New Zealand fur seal (Arctocephalus forsteri) also died unexpectedly in its enclosure. It had been listless with loud respirations since capture. At necropsy there was no blood around the head, neck or mouth, and no acute external injuries were identified. An area of induration was, however, present over the snout with fragmentation of underlying bones. The maxilla was freely mobile and CT scanning revealed multiple comminuted fractures of the adjacent facial skeleton. Examination of the defleshed skull showed fragmentation of the facial skeleton with roughening of bones in keeping with osteomyelitis. Death was attributed to sepsis from osteomyelitis of a comminuted midfacial fracture. These cases demonstrate two unusual and occult conditions that may be present in recently retrieved juvenile fur seals. Failure to establish the correct diagnosis rapidly may result in death soon after capture. The usefulness of imaging techniques such as CT scanning in delineating underlying injuries prior to necropsy is clearly demonstrated.     

Histologic dating of bruises in moribund infants and young children

It is generally held that leukocytes are found within bruised subcutaneous tissues within 4–12 h of injury as part of a standard cellular response to trauma. As a corollary, the absence of leukocytes is often cited as evidence of more recent injury. To investigate how long after injury it may be before a leukocyte response occurs selected bruises from three children aged 27, 11, and 3 months, respectively, were examined microscopically. All of the children had sustained lethal head trauma, with survival on life-support equipment for some time in hospital, and with bruises of at least 24-h duration confirmed by medical evaluation (at 30, 44, and 79 h from the time of initial medical evaluation to death). Histologic examination of selected lesions in all three cases revealed extravasation of red blood cells within subcutaneous tissues, but no leukocyte infiltration or other cellular reaction. Other bruises in these children exhibited a standard inflammatory response. This study has shown that selected bruises in three children were present for at least 30 h without a leukocyte infiltrate. Caution should, therefore, be exercised in assigning too rigid a time course to bruising in infants and young children based on a lack of a vital reaction, as the absence of leukocytes within soft tissues of bruised skin in these cases may not necessarily indicate that the injuries are recent. Variability in tissue response may also occur in different bruises in the same individual. Whether severe craniocerebral trauma played a role in delaying the cellular response in these particular injuries is unclear.     

Diagnostic yield and characteristic features in a series of decomposed bodies subject to coronial autopsy

A study was undertaken of 629 cases autopsied at Forensic Science SA, Adelaide, Australia over a 10-year period from 1994 to 2004 where significant decomposition had been documented. The age range of victims was 10 months to 92 years (mean 51.5 ± 18.1 years). There were 498 males (79%) and 131 females (21%) (M:F = 3.8:1). Deaths in 289 of the 629 cases (46%) were due to natural causes, with 179 suicides (28%), 83 accidents (13%), and 36 homicides (6%). The cause of death was ascertained in 89% of cases and the manner of death in 93% of cases. In 35 cases (6%) both the cause and manner could not be determined. Numbers of suicides were higher in younger age groups while deaths from organic illnesses predominated in later life. The number of cases in summer was significantly greater than in winter. Despite technical difficulties in handling decomposed bodies, and artifactual alteration of tissue structure and microscopic features, the autopsy was still a useful diagnostic exercise. While it is likely that more information may be gleaned from fresh bodies in perfectly preserved states, decomposed bodies may reveal significant anatomical and pathological features that enable both the cause and manner of death to be established.     

Subarterial ventricular septal defect in an infant with sudden unexpected death: cause or coincidence?

A case of unexpected death in a 3-month-old infant with a subarterial ventricular septal defect (VSD) is described. Although VSDs in medically stable infants are not usually associated with fatal outcome, this case and review of the literature suggest that a small percentage of such patients may have an increased risk of sudden death.     

Pulmonary Malacoplakia in a Child

Pulmonary malacoplakia is a rare condition with only five previously reported cases in the literature, all occurring in adults. We describe a case of malacoplakia of the lung in a 6-year-old female with acute lymphoblastic leukemia in remission and a Rhodococcus equi pneumonia and septicemia. The case demonstrates that pulmonary malacoplakia can occur in immunocompromised pediatric patients and that malacoplakia should, therefore, be added to the list of causes of nodular lung infiltrates in immunocompromised children.