Small – but fatal: Postmortem computed tomography indicated acute tonsillitis

The objective of this case report was to highlight the benefit of postmortem imaging in the detection of focus of infection and inflammation in minor accessible neck regions. However the cooperation of postmortem imaging, external inspection and autopsy was constructive. Forensic imaging included a routine whole-body postmortem computed tomography (PMCT) using a dual-source CT scanner (Flash Definition, Siemens, Forchheim, Germany). Initial external inspection and subsequent autopsy were performed. The imaging results revealed focused emphysema of the neck descending to the mediastinum. External inspection showed unusual, cervical greenish discoloration; the autopsy exposed swollen palatine tonsils; and acute, purulent tonsillitis was the focus of infection. Ultimately an acute heart failure due to a septic shock resulted. Postmortem imaging supports medico-legal investigation with external inspection and autopsy in detecting the focus of infection in the palatine tonsils and in challengingly reachable anatomic areas such as neck regions. Literature recommends computed tomography with contrast media and magnetic resonance imaging for the detailed visualization of this body region for the living. According to our experience, we support this recommendation also for the deceased.
Source: Journal of Forensic Radiology and Imaging - Category: Radiology Source Type: research