Usefulness of pericardial and pleural fluids for the postmortem diagnosis of sepsis

J Forensic Leg Med. 2014 Nov:28:15-8. doi: 10.1016/j.jflm.2014.09.006. Epub 2014 Sep 19.


The purpose of this study was to evaluate the postmortem distributions of procalcitonin (PCT), C-reactive protein (CRP), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) and soluble interleukin-2 receptor (sIL-2R) levels in postmortem serum from femoral blood, pericardial fluid and pleural fluid in a series of sepsis-related fatalities (12 subjects) and control cases (20 subjects) that underwent medico-legal investigations. Our aim was to assess the diagnostic potential of the results obtained from pericardial and pleural fluid analysis in identifying sepsis-related deaths. All sepsis-related cases had a documented, clinical diagnosis that was established in vivo during hospitalization. Pneumonia was the main infectious focus identified during autopsy and histology. Pseudomonas aeruginosa, Klebsiella pnemoniae and Escherichia coli were the most commonly identified bacteria in blood and lung tissue cultures. The preliminary results corroborate the usefulness of PCT, CRP, sTREM-1 and sIL-2R determination in postmortem serum for the identification of sepsis-related deaths. Moreover, the data suggest that, as far as PCT, CRP, sTREM-1 and sIL-2R measurements are concerned, pericardial and pleural fluids can be considered suitable alternatives to postmortem serum should femoral blood prove unavailable at autopsy.

Keywords: Autopsy; Pericardial fluid; Pleural fluid; Postmortem biochemistry; Sepsis biomarkers.

MeSH terms

  • Aged
  • Autopsy*
  • Biomarkers
  • C-Reactive Protein / analysis
  • Calcitonin / analysis
  • Calcitonin Gene-Related Peptide
  • Female
  • Humans
  • Male
  • Membrane Glycoproteins / analysis
  • Middle Aged
  • Pericardium / chemistry*
  • Pericardium / microbiology
  • Pleura / chemistry*
  • Pleura / microbiology
  • Prospective Studies
  • Protein Precursors / analysis
  • Receptors, Immunologic / analysis
  • Receptors, Interleukin-2 / analysis
  • Sensitivity and Specificity
  • Sepsis / blood
  • Sepsis / metabolism*
  • Sepsis / mortality*
  • Triggering Receptor Expressed on Myeloid Cells-1


  • Biomarkers
  • CALCA protein, human
  • Membrane Glycoproteins
  • Protein Precursors
  • Receptors, Immunologic
  • Receptors, Interleukin-2
  • TREM1 protein, human
  • Triggering Receptor Expressed on Myeloid Cells-1
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide