ECP 2023 Abstracts

S147 Virchows Archiv (2023) 483 (Suppl 1):S1–S391 13 E-PS-01-006 Diabetes-induced dementia: review of histopathological changes on autopsy B.M. Bernal G.*, L.F. Salas *Universidad Pedagogica y Tecnológica de Colombia, Colombia Background & objectives: Diabetes-induced dementia diagnosis is frequent by use of glial damage biomarkers. Advanced glycation end products (AGE) affect secretion of brain-derived neurotropic factor- BDNF, cause of cognitive decline In vivo, with limited histopathologi- cal data, aims in order to state of the art. Methods: Systematic review was elaborated with Key words BDNF and Diabetes, BDNF and histopathology, BDNF and Dementia, in order to find morphological characteristics when BDNF is risen; The case defini- tion were articles with the presence of BDNF levels in serum samples or Cerebral spinal fluid and clinicopathological features of Diabetes. Results: The search results were extracted from 33 randomized con- trolled trials. Data extracted from abstract and full text reading. Clin- icopathological findings showed not relationship between increased BDNF levels and interventions against Hyperglycaemic status except exercise and movement. Only two studies shown unspecific histopatho- logical changes and then we could find a relevant topic to research on Autopsies in order to answer the question that Diabetes damage on cerebral tissue could be prevented earlier. Conclusion: Despites their pathological changes on glial and bio- chemical factors, neuroinflammation without microorganisms still being controverted. Injury to blood brain barrier like that observed on aging, occasionally described on autopsy settings, with disfunction in aerobic metabolic pathways, can be related with increase of amyloid B deposits and chronical hyperglycaemia. Histopathological features about these phenomena could be linked. Funding: 2496-2498 DIN UPTC E-PS-01-007 Streptococcus pyogenes sepsis in a 3-year-old girl, apropos of an autopsy study S. Blasco Muñoz*, A. Sánchez Espinosa, A. Ortiz González, C.A. Capozzi, D. Pérez Parra, E. Guillén Saorín, E. Aguilar Navarro, C. López Peña *Complejo Hospitalario Universitario de Cartagena, Spain Background & objectives: A 3-year-old girl consulted for fever, vom- iting and diarrhoea of 12 hours of evolution. After an emergency room examination, she was discharged with a diagnosis of gastroenteritis, and was readmitted a few hours later in a state of shock. Methods: After a torpid evolution, the patient died and we performed a postmortem examination. Samples were taken for histological and microbiological study. Macroscopic findings included: petechial exan- thema, chin skin erosion, pulmonary oedema and congestion, blackish appearance of the adrenal glands, fibrinoid material in the urinary blad- der wall, subgaleal haemorrhage, and meningeal empyema. Results: Histologically the most relevant findings were: cerebral oedema and hyaline thrombi, meningeal haemorrhage, meningitis focus, pulmonary oedema and haemorrhage, adrenal haemorrhage, renal septic embolisms, cystitis, intravascular leukemoid reaction. Culture results were positive for Streptococcus pyogenes in lung tissue, meningeal and bladder fibrinoid material. The histopathologic and microbiology find- ings, in the context of systemic multiorgan failure due to sepsis caused by Streptococcus pyogenes, justify the triggering cause of the Exitus. Conclusion: Streptococcus pyogenes septic shock induces hypo- volemic shock, which justifies hypotension, as well as hypoxic- ischemic damage at the multiorgan level. In addition, it can produce toxic shock by means of streptococcal pyrogenic exotoxins that act as superantigens, producing excessive immune response and a state of procoagulation. The accompanying leukemoid reaction, consisting of an increase in the immature-looking leukocyte population in peripheral blood, can occur in response to many diseases, including acute or chronic infec- tious processes. E-PS-01-008 An unusual case of disseminated actinomycosis with cardiac, cerebral, and patchy pulmonary involvement L. Chinezu*, I. Iurian, C. Carasca *G.E. Palade UMFST Targu Mures, Romania Background & objectives: Actinomycosis is an infrequent, slowly progressive bacterial infection, with cervico-facial, thoracic, abdomi- nal, or pelvic region involvement. Hematogenous seeding from a pri- mary site could be the cause of disseminated actinomycosis (DA). The sudden death was rarely reported in DA. Methods: We presented the case of a 77-years-old male found dead at home without previous medical history. The autopsy was performed at the Institute of Forensic Medicine of Targu Mures, Romania. Results: Gross examination of cerebral and lung tissue was non-spe- cific. Heart examination revealed multiple patchy, discoloured, and haemorrhagic areas on left ventricular sections. Microscopically, abun- dant suppurative inflammation and characteristic structures composed of central sulphur granules surrounded by an eosinophilic material suggestive for Actinomyces were seen in subarachnoid space, cerebral tissue, and myocardium. The examination of the lungs revealed diffuse acute oedema and small foci of mixed inflammatory infiltrates with only few structures suggestive for Actinomyces. The final diagnosis was DA associated with extensive myocarditis, meningoencephalitis, and patchy bronchopneumonia. Conclusion: As in our case, sudden cardiac death can occur in DA and it can be related to extensive myocarditis. The better characterisation of this rare disease is needed to improve our understanding, to minimize morbidity, and to prevent death. Funding: FDI internalization of higher education E-PS-01-009 A sudden infant death syndrome in a full-term neonate: autopsy findings S. Emoke-Andrea*, A. Raicea, L. Chinezu *G.E. Palade UMFST Targu Mures, Romania Background & objectives: Sudden infant death syndrome (SIDS) of a previously healthy infant occurring within the first postnatal week is a very rare occurrence. We present the case of a full-term neonate who was found unresponsive after breastfeeding. Methods: A 4 day-old male infant was pronounced dead after car- diopulmonary resuscitation with endotracheal intubation. A complete autopsy was performed at Institute of Forensic Medicine, Targu Mures, Romania. Results: Gross examination revealed whitish material predominantly in the trachea, bronchi, and in a small amount in the stomach. The organs were congested. Extensive histological examinations of lung tissue identified amorphous material, suspected to be aspirated milk in the bronchi, bronchioles, and alveoli, associated with collapsed and emphysematous alveoli. Inflammation was not evident in lung sec- tions. No other pathological findings were observed at macroscopic and microscopic examinations of the organs. The final diagnosis was SIDS due to a suddenly developed accidental milk aspiration. Conclusion: In many cases of SIDS, an extensive histopathological assessment is necessary for the identification of the cause of death. As not all infants exhibit respiratory symptoms, when they aspirate, the post- mortem diagnosis of milk aspiration can be a challenge for the clinician