Usefulness of postmortem computed tomography before forensic autopsy for alerting forensic personnel to tuberculosis infection

Since May 2009, we have performed multislice computed tomography (MSCT) prior to forensic autopsy for cases of suspicious death. In the present case, innumerable widely scattered nodules in both pulmonary fields on MSCT were indicative of miliary tuberculosis (TB). At autopsy, both lungs were submerged in formalin fluid immediately after removal from the body. Miliary TB was finally diagnosed based on microscopic findings. TB is a disease that autopsy room workers need to be aware of to protect themselves. Unfortunately, because little medical information about deceased individuals is usually available before forensic autopsy, the diagnosis of TB is frequently not made until autopsy. This leads to a much higher incidence of TB in autopsy room staff members even if they wear protective clothing. Therefore, MSCT before forensic autopsy may identify suspected cases of miliary TB in advance and thus help to prevent TB infection in forensic autopsy personnel.