Fatal meningococcal meningitis in a 2-year-old child:A case report

BACKGROUND In fatal cases of meningococcal septicemia, bacteriological diagnosis may not be straightforward due to postmortem replication and relocation of endogenic microflora. In medicolegal practice, aside from routine autopsy and histopathology, also other diagnostic methods, such as microbiological tests,immunohistochemistry and polymerase chain reaction(PCR), are used to examine body fluids and tissues.CASE SUMMARY We present the case of sudden death in a 2-year-old child. The patient died approximately 30 min after hospital admission before any routine diagnostic procedures were undertaken. Presence of whole-body rash and fulminant course of the disease raised suspicion of meningococcal septicemia. An autopsy was performed seven days after death when the body showed the signs of late postmortem decomposition. No etiological factor of septicemia could be identified based on macro-and microscopic findings. However, PCR demonstrated the presence of genetic material of group W Neisseria meningitidis in patient's cerebrospinal fluid and blood.CONCLUSION Microbiological PCR should be conducted postmortem whenever a specific etiological factor could not be identified with conventional methods.

Organic carbon monoxide prodrug, BW-CO-111, in protection against chemically-induced gastric mucosal damage

Metal-based carbon monoxide(CO)-releasing molecules have been shown to exert antiinflammatory and anti-oxidative properties maintaining gastric mucosal integrity.We are interested in further development of metal-free CO-based therapeutics for oral administration.Thus,we examine the protective effect of representative CO prodrug,BW-CO-111.in rat models of gastric damage induced by necrotic ethanol or aspirin,a representative non-steroidal anti-inflammatory drug.Treatment effectiveness was assessed by measuring the microscopic/macroscopic gastric damage area and gastric blood flow by laser flowmetry.Gastric mucosal mRNA and/or protein expressions of HMOX1,HMOX2,nuclear factor erythroid 2-related factor 2,COX1,COX2,iNos,Anxa1 and serum contents of TGFB1,TGFB2,IL1 B,IL2,IL4,IL5,IL6,IL10,IL12,tumor necrosis factorα,interferonγ,and GM-CSF were determined.CO content in gastric mucosa was assessed by gas chromatography.Pretreatment with BW-CO-111(0.1 mg/kg,i.g.)increased gastric mucosal content of CO and reduced gastric lesions area in both models followed by increased GBF.These protective effects of the CO prodrug were supported by changes in expressions of molecular biomarkers.However,because the pathomechanisms of gastric damage differ between topical administration of ethanol and aspirin,the possible protective and anti-inflammatory mechanisms of BW-CO-111 may be somewhat different in these models.