Abstract
In paleopathology, morphological and molecular evidence for infection by mycobacteria of the M. tuberculosis complex (MTC) is frequently associated with early death. In the present report, we describe a multidisciplinary study of a well-preserved mummy from Napoleonic times with a long-standing tuberculous infection by M. tuberculosis senso stricto who died at the age of 88 years of focal and non-MTB related bronchopneumonia. The well-preserved natural mummy of the Royal Bavarian General, Count Heinrich LII Reuss-Köstritz (1763–1851 CE), was extensively investigated by macro- and histomorphology, whole body CT scans and organ radiography, various molecular tissue analyses, including stable isotope analysis and molecular genetic tests. We identified signs for a long-standing, but terminally inactive pulmonary tuberculosis, tuberculous destruction of the second lumbar vertebral body, and a large tuberculous abscess in the right (retroperitoneal) psoas region (a cold abscess). This cold abscess harboured an active tuberculous infection as evidenced by histological and molecular tests. Radiological and histological analysis further revealed extensive arteriosclerosis with (non-obliterating) coronary and significant carotid arteriosclerosis, healthy bone tissue without evidence of age-related osteopenia, evidence for diffuse idiopathic skeletal hyperostosis and mild osteoarthrosis of few joints. This suggests excellent living conditions correlating well with his diet indicated by stable isotope results and literary evidence. Despite the clear evidence of a tuberculous cold abscess with bacterioscopic and molecular proof for a persisting MTC infection of a human-type M. tuberculosis strain, we can exclude the chronic MTC infection as cause of death. The detection of MTC in historic individuals should therefore be interpreted with great caution and include further data, such as their nutritional status.
Highlights
Human remains from previous cultures represent a highly valuable bioarchive suitable for the reconstruction of living and disease conditions in past populations, including evidence for infectious diseases, trauma and certain metabolic disorders [1]
The first identified pathogen was the human-pathogenic M. tuberculosis complex (MTC); despite numerous studies gathering ample information about infection frequencies, and the appearance of various substrains involved in the dissemination of the disease in the last 5,000 years [6,7,8,9], still many questions remain open
The “outcome” of such studies strongly depends on the material with respect to the tissue available and the state of tissue preservation
Summary
Human remains (mummies and skeletons) from previous cultures represent a highly valuable bioarchive suitable for the reconstruction of living and disease conditions in past populations, including evidence for infectious diseases, trauma and certain metabolic disorders [1]. The recent significant advances in radiological techniques, molecular tests (ancient DNA, “proteomics”), radiocarbon (absolute dating) as well as stable isotope analysis (diet, localisation of origin) provide a growing body of valuable information on historic individuals. In this regard, complete mummies are much more informative than mummy parts or skeletal remains alone [2]. Particular attention has recently been paid to various infectious diseases, since these diseases have been assumed as to be major causes of death in past populations [4] In this regard, the successful molecular identification of ancient pathogen DNA (first accomplished in 1993 by Spigelman and Lemma [5]) opened the way for a better understanding of the role of infectious diseases. Each case with a proven longstanding active disease, but without intimate link to the cause of death, is very instructive
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