Open AccessA case report on death from acute bacterial cholangitis accompanied by von Meyenburg complexes
Author(s) -
Noriko Watanabe,
Shinya Ohno,
Moe Sakuma,
Mayo Kuriwaki,
Motoki Miura,
Masahiko Kuroda
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000025526
Subject(s) - medicine , pathology , autopsy , amplicon , 16s ribosomal rna , ribosomal rna , sepsis , polymerase chain reaction , gene , biology , genetics
Rationale: In some cases, autopsy is the first opportunity to find a previously unrecognized critical infection. Pathogens are identified by various methods, such as microscopic examination, special stains, culture tests, and immunohistochemistry. Here, we report a case of 16S ribosomal RNA (rRNA) gene sequencing using a postmortem formalin-fixed, paraffin-embedded (FFPE) tissue, which was useful for identifying pathogenic microbes. Patient concerns: Autopsy was performed on an 87-year-old man who had chronic renal failure and had developed sepsis from a central venous catheter infection 10 days before his death. Prior to these events, von Meyenburg complexes (VMCs) were also found during regular checkups. Diagnosis: Postmortem microscopic examination revealed acute purulent cholangitis with numerous microabscesses, accompanied by VMCs. Gram-negative rods were observed in some microabscesses, which were considered causative pathogens. Interventions: 16S rRNA gene sequencing using postmortem FFPE tissue Outcomes: Pseudomonas aeruginosa was identified, different from the one detected in the central venous catheter culture while alive. Lessons: 16S rRNA gene sequencing is a useful tool for identifying pathogenic microbes in postmortem FFPE tissues. This technique may be useful for amplicon sizes of approximately 100 bp or less.