Dlvision of Forenslc Sclences Continued

Georgia Bureau of lnvestigation 20 17 -'l 00'l 37 9: Autopsy

Ffleen Hematoxylin and Eosin slained slides and one iron stained sllde with appropriate control
are evaluated.

Slide Key:

1 - Midbrain
2 - Pons
3 - Medulla, cerebellum
4 - Lell hippocampus
5 - Right hlppocampus, thalamus and superllcial cortex
6 - Rlght fronlal cortex, superficlal cortex
7 - Dura, mesenteric lymph node
8 - Thymus, thyroid, eplglottls, trachea
9 - Rlght upper lung, heart (lefi ventricle lnf,ow, atria)
10 - Right mlddle lung, heart (lefr ventricle out flow)
11 - Right lower lung, heart (ventricular septum, rlght ventrlcle inflow and outlow)
12 - Lefi lung, liver
13 - Spleen, pancreas, adrenal
14 - Kidneys, adrenal
15 - Spinal cord

The following lTndings are observed:

Brain:
Sections demonslrate normal cytoarchiteclure. The gray and while matter tissue ls
unremarkable. The leptomeninges dlsplay congested vessels, occaslonal mild hemorrhage
and occaslonal lymphocytes. Mlcroorganlsms are not identlffed.

Heart:
The myocytes are unremarkable, and myofrber organlzation is normal. The myocardium is free
of lnllammalion and lTbrosis.

Lungs:
The alvoolar development is appropriate for age. The alveoli are normally expanded. The
alnvays are patent and unremarkable. There is no evidence of infecous or intammatory
process. The lron stain is negatlve.

Llver:
The parenchymal archftecture ls preserved, and lhe hepatocytes are unremarkable. The portal
spaoes are free of inf,ammation and fibrosls. Bile ducts are present and unremarkable.

Kldneys:
The sectlons show normal architecture with unremarkable glomerul, vessels and tubules.

Adrenals:
The parenchyma dlsplays extenslve hemonhage and ls free of inflammation.

Other:
Olher ssue sectlons are well preserved and show no signillcant pathologlc abnormalities.

OTHER PROCEDURES:

1. Alr dried bloodstain card collected and held for serology.

2. Speclmens collected for toxlcology: heart blood, une and lle
3. Vtreous submltted for electrolyte and glucose analysls.
4. ssue sectlons (15) submltted for hlstology.
5. Pedlahlx bloodstaln card prepared and submltted for metabollc screenlng.
6. Spcimens submltled for cultures and infectious dlsease analysls: nasopharyngeal swabs,
braln surface swabs, cerebral splnal fluld

Rcport Date: O5l 1 012017 Paga 5 of 7

Report id: MCXOLITS0I FJY4
Template Rcv. 2015-1 2-ll
Dlvlsion of Forenslc Sclences Contlnued
Georgla Bureau of lnvestlgatlon 2017.1001379: Autopsy

7. Materlals/records reviewed: Brlght Pediatrics

SUMMARY OF FINDINGS/PATHOLOGIC DIAGNOSES:

l. Menlngltls
A. Nelssria menlngitldes nongroupable detected (Centers of Disease Control analysis)
B. Mild subarachnold hemonhage
C. Features ofWaterhouse-Friderichsen syndrome

ll. Toxicology analysis, negative

lll. Vltreous electrolytes and glucose analysis, wilhin normal limlts

lV. Metabollc scren, elevated CAH 17-OHP (7 ng/ml). lkely postmortem arlifact

V. Absence of trauma

OPINION/SUMMARY:

Thls 2O-monthold whlte male child, Terry Gibson, reportedly had a febrile lllness and was
found unresponslve, pulseless and apnelc ln a crib al hls resldence. The complt autopsy
and postmortem anclllary studles reveal menlnglts as hls cause of dealh. Nelsserla
meningitides organlsm ls detected in poatmortem lnfectlous diseas studles. The autopsy
addltlonally discloses bllateral adrenal hemorhage, wlch ls characterlstlc of
Waterhouse-Friderlchsen syndroma and typically assoclated wlth fulmlnant dlsease. No
additlonal analomlc abnormalles or lrauma ls ldentlfied as causative or contrlbutory to hls
death.

CAUSE OF DEATH:

Menlngltls

MANNER OF DEATH:

Natural

Only thosc itcms dlscugcd ln thc rcsults aboyc wcro rnrfyzcd for thls rcport. Thc abovc roprcecnts thc
ntcrprcteonsJoplnions of thc undcrslgncd anelyst Evldcncc analyzed ln thls rcport will bc rcturncd to the
submlttlng agcncy. Blologlcal cvidcncc {body lluids and tissucs) and ffrc debrs cdr.c-ts wlll bc dettroycd alter
one ycar. Thla rcport may not bc rcproduccd excapt in full wlthout written pcrmlsslon of the laboratory.

Technlcal notce and data supportlng tlrc conclugions and findlngs ln thls rcport are malntalncd wtthln the
laboratory csc rrcords.

Thls cssa may contaln cvldence that must bc preservcd ln accordancc wlth O.C.G.A. S f 7-6-56.

P
Lora Daisarv
^Dir. of Pediatric Pathology
40/'270-8186
Related Agencles:
Conasauga Judlcial Clrcull
GB|-Medlcal Examlner-HQ DOFS ACN: DARRISAW

Rcport Datc: 0il10n017 Pegc 6 of 7

Rcport ld: lCXOl-/tTS0l FJY|
Template Rcv. 2015-12-11
 DMclon of Forenslc Sclences Contlnued
Oeorgla Bureu of lnveotlgdon
117.1001379: Autopsy

Chlld Fatllly Revw Board

Chlld Abuge Prolocol Commlttee-Whltf eld Co.
Whltllsld Co. Dlstlc{ Attomey
Whltfeld Co. Sheriffs Offlce ACN:17340

End of Official Report

Rcport Dlc: 0511012017 Pqcl olf

Rcpo ld: tCXOlS0lFJYl
Tcnpld. Rcv.2011241