Sudden death due to an unrecognized cardiac hydatid cyst

Echinococcosis is an endemic disease, most common in sheep-raising communities, usually caused by the larval or cyst stage of the tapeworm Echinococcus granulosus. Isolated cardiac hydatid cyst is uncommon at any age, occurs through the coronary circulation, and accounts for less than 3% of all hydatid disease. We describe a case of an 1%-year-old female, who died suddenly. The post-mortem examination revealed an isolated cyst in the left ventricle of the heart with intact wall. The cytologic examination of the cyst fluid demonstrated the presence of the characteristic scolices and hooklets and established the diagnosis of cardiac hydatid cyst. The present case is of special interest because of the rare primary localization and the onset of sudden death in a young person as the initial manifestation of the disease.     

Biochemical pathways generating post-mortem volatile compounds co-detected during forensic ethanol analyses

In this contribution are presented the fermentations of the main substrates present in a decaying corpse, namely carbohydrates, amino acids, glycerol and fatty acids, generating the post-mortem volatile compounds that could be detected along with ethanol during the forensic ethanol analysis. The available literature (preferably reviews) on microbial metabolic pathways (enzymes, substrates, conditions) that are implicated in the formation of these volatiles has been reviewed. The microbial formation of the following volatiles is supported by the presented biochemical data: ethanol, acetaldehyde, acetone, 2-propanol, 1-propanol, 1-butanol, isobutanol, isoamyl alcohol, d-amyl alcohol, acetate, propionate, butyrate, isobutyrate and ethyl esters (mainly ethyl acetate). The extracted information was correlated with the existing forensic literature on the post-mortem detected volatiles. The significance of the microbial produced volatiles on the selection of an appropriate internal standard for the ethanol analysis has been considered. Finally, the possible contribution of the presence of volatiles in the interpretation of ethanol analysis results in post-mortem cases is discussed.