İbrahim ÜZÜN, Ömer MÜSLÜMANOĞLU, Yalçın BÜYÜK

Adli otopsilerde tüberküloz kaynaklı ölüm olguları ışığında otopside biyo-güvenlik

1998-2002 yılları arasında otopsileri yapılan toplam 15 tüberküloz kaynaklı ölüm olgusu saptanmış olup, olguların hiç birinde ölüme etkili travmatik değişim saptanmamıştır. Olguların 14'ü erkek (% 93.33) ve 1'i kadın (% 6.66) olup, yaş dağılımı 61 ve 70 yaşlar arası 2 (% 13.33), 51-60 yaşlar arası 1 (% 6.66), 41-50 yaşlar arası 4 (% 26.66), 31-40 yaşlar arası 6 (% 40.00), 21-30 yaşlar arası 1 (% 6.66), 20 yaş altı 1 (% 6.66) olarak belirlenmiştir. Olguların ölüm şekli incelendiğinde 11 olgunun ölü olarak bulunduğu ve bu olgulardan 8'nin sokakta ölü olarak bulunduğu, bu kişilerin sokaklarda yaşayan kişiler olup evsiz, kimsesiz oldukları bildirilmiştir. 3 olgu evde ölü olarak bulunmuş ve bu olgulardan ikisinin de kimsesiz olduğu, evde yalnız yaşadıkları bildirilmiştir. Olguların otopsilerinde saptanan makroskobik bulgular incelendiğinde; olguların tümünde akciğerlerde yaygın plevral yapışıklar olduğu ve özellikle apikal bölge olmak üzere olguların tümünde akciğerlerde yaygın kavernler olduğu saptandı. Bronşa açılmış ve içi kanla dolu kavern varlığı ise 3 olguda saptandı. Bu 3 olguda aynı zamanda mide içinde ve solunum yollarında da kan varlığı görüldü. Bu tüberküloz kaynaklı ölüm olguları ışığında otopside enfeksiyon bulaşımı sorunu literatür ışığında tartışılmış ve otopsi ortamında enfeksiyona karşı alınacak önlemlerin önemine vurgu yapılmıştır.

Tuberculosis-related deaths in forensic autopsies and biosafety considerations

To discuss the infectivity potential of autopsy room, autopsy reports of pure-tuberculosis-related death cases detected between the years 1998 and 2002 were retrospectively analyzed. Of the total 15 cases, 14 (% 93.33) were male and 1 (% 6.66) was female. There were 2 cases in 61- 70 age group, 1 in 51-60, 4 in 41-50, 6 in 31-40, 1 in 21-30 and 1 in below 20 age groups. There were no traumatic signs in the cases. Of the cases, 11 were found dead outdoor and 8 of these cases were reported to be homeless. The number of the cases found dead in their houses was 3 and these cases were reported to have no relatives. At the autopsy of these cases, there were abundant cavernous formations particularly in the apical region of the lungs in all cases. Blood-filled caverns opened into bronchus were detected in 3 cases. In these cases, the presence of blood in gastric content and respiratory airways was also detected. The problem of transmission of infections at autopsy was discussed in the light of literature and possible precautions against infection during autopsy were stressed.

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