Prevalence of tuberculosis: A study in forensic autopsies

Abstract

Background: Tuberculosis is a major cause of morbidity and mortality in developing countries. There are many cases of tuberculosis which remain undiagnosed and are diagnosed only at autopsy. Materials and Methods: This retrospective study was conducted on cases brought for forensic autopsy in a tertiary care medical centre from the year 2003 to 2012. The history, post-mortem findings, and histopathological findings of the cases were meticulously studied and analyzed. Results: Out of the total 4,415 autopsies, 74 cases had findings of tuberculosis. Males outnumbered females, and the highest number of tuberculosis cases was observed in males in the age-groups of 40 to 50 years (32.43%) followed 50 years and above (25.67%). Tuberculosis as to be the primary cause of death was observed in 28.38% of the cases, of which 22.97% were pulmonary while 5.41% were cases of disseminated/extrapulmonary tuberculosis. In the lung, active tuberculosis was observed in 34.28%, i.e., granulomatous inflammation with caseation necrosis (27.14%) or granulomatous inflammation with caseation necrosis and tubercular pneumonia (7.14%). Suspicious cases of inactive tuberculosis, i.e., fibrosis and calcification was observed in 65.71% of the cases. Conclusion: The chance finding of tuberculosis in forensic autopsy cases in this study highlights that there are undiagnosed cases of active tuberculosis who are not seeking proper medical attention and these cases may pose as a source of transmission to the general public, health-care providers and mortuary staff.