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Retrospective Analysis of Histopathological and Microbiological Correlation of Autopsy Series

Background: In this retrospective observational study, we reviewed macroscopic postmortem examinations of surgical Intensive Care Unit (ICU) patients who died from suspected sepsis or septic shock.

Methods: All 125 Patients who were admitted in the ICU and subsequently died and cause of death labeled as sepsis/septic shock. Clinical data and postmortem findings were documented in all patients.

Results: The study included postmortem results which included gross, histopathology and microbiology. The main causes of death as reported in the patient history were sepsis with multiple organ dysfunction syndrome (70%) and cardiorespiratory failure (30%). Pathologies were detected in the lungs in 18 cases, kidneys/urinary tract 05 cases, gastrointestinal tract 02 cases, cardiovascular system 09 cases, liver 20 cases, spleen 01 case, central nervous system 30 cases, and pancreas 08 cases and in 32 cases multiple organ pathology was seen like lung, brain, liver. The autopsy and microbiological examination revealed confirmatory growth and septic focus in 40 (32%) cases only. The microbiological isolates were obtained from CSF, heart blood, ascitic fluid, pleural and pericardial fluid and tracheal aspirates. Most common isolate was Klebsiella in 25 cases.

Conclusion: Relevant postmortem findings explaining death in surgical ICU patients who died because of sepsis/ septic shock were a continuous septic focus in approximately 40%, primary CNS pathology 37.5% cardiac pathologies in 7.2%. The most frequently affected organs were the brain, liver, lungs. Multiple organ system was also involved in 32 cases and disseminated fungal infection was the cause of death in 2 cases.

Author(s): Tanushri Mukherjee, Soma Mukherjee, Nalin Singh and Anshuman Singh

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