CASE REPORT
Fatal systemic (paradoxical) air embolism diagnosed by postmortem funduscopy
Lucy M. Bradley MD,
Anna G. McDonald MD,
Patrick E. Lantz MD,
Lucy M. Bradley MD
Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
Search for more papers by this authorAnna G. McDonald MD
Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Search for more papers by this authorCorresponding Author
Patrick E. Lantz MD
Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Correspondence
Patrick E. Lantz MD, Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Email: [email protected]
Search for more papers by this authorLucy M. Bradley MD,
Anna G. McDonald MD,
Patrick E. Lantz MD,
Lucy M. Bradley MD
Department of Pathology, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
Search for more papers by this authorAnna G. McDonald MD
Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Search for more papers by this authorCorresponding Author
Patrick E. Lantz MD
Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
Correspondence
Patrick E. Lantz MD, Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Email: [email protected]
Search for more papers by this authorFirst published: 15 June 2021
Presented at the 72nd Annual Scientific Meeting of the American Academy of Forensic Sciences, February 15–19, 2021, held virtually.
Abstract
Air embolism is often unrecognized and underreported. Published case reports or case series describe only rare fundal examinations of retinal air emboli (RAE)—a distinctive sign of systemic air embolism. We report an infant, found unresponsive at home, who died in the emergency department after unsuccessful resuscitative efforts. Before the autopsy, diagnostic RAE were recognized and imaged during postmortem funduscopy. Postmortem radiography and an autopsy confirmed systemic (paradoxical) air embolism due to inflicted abdominal and thoracic blunt force injuries. While a few descriptions and illustrations of RAE occur in case reports, we found no published photographic images of RAE in infants, children, or adults. This case report describes and photographically documents classic RAE associated with fatal systemic (paradoxical) air embolism. Complementing postmortem radiography and judicious autopsy techniques, the detection of RAE can aid pathologists in diagnosing systemic air embolism.
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