Sudden death in a child following jellyfish envenomation by Chiropsalmus quadrumanus: case report and autopsy findings

Article Abstract:

A case report is presented to illustrate the fatal effect of a sting by a jellyfish (Chiropsalmus quadrumanus ) on a five-year-old boy. The boy was swimming in the Gulf of Mexico at Crystal Beach, Texas when he began screaming. He was found to have jellyfish tentacles wrapped around his left arm. These were removed and meat tenderizer was placed on the affected area. The patient was then taken via ferryboat to the emergency department of a hospital. He was brought from the ferryboat to the hospital via emergency transport. After 20 minutes, the boy became sleepy and listless; paramedics began chest compressions when he went into shock. By the time of arrival at the hospital, approximately 39 minutes after the envenomation, the patient had no spontaneous respiration or movement and his extremities were cool. Intubation was performed and frothy secretions were suctioned from his throat. Drugs were given to stimulate the heart, but these advanced life support efforts were finally ceased one and one-half hours after the injury. Autopsy showed that the lungs contained large amounts of foamy material and that hemorrhage had occurred in the heart. The marks of the tentacles were clearly visible along the left arm. It was initially thought that death was due to the sting of a Portuguese man-of-war (Physalia physalis), but studies of material removed from the patient's skin showed that the marine animal had been Chiropsalmus quadrumanus, also called the sea wasp. This jellyfish is transparent and hard to see in the ocean. A reaction of the type exhibited by the patient is unusual in the US, which lacks the most toxic jellyfish. The patient's condition deteriorated too quickly for treatment anywhere but in an intensive care facility. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Patient outcomes, Mortality, Bites and stings, Bites (Injuries), Stings (Injuries), Hydrozoans

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Lincoln, Kennedy, and the autopsy

Article Abstract:

When President Abraham Lincoln was assassinated in 1865, the results of the autopsy were made public, which allowed the nation to accept the government's account of the incident and grieve properly over the loss of its leader. When President John F. Kennedy was assassinated in 1963, the autopsy records were not as widely publicized, leading to continuing speculation about the incident. When one doctor was able to review the autopsy records, he accepted the conclusion of the Warren Commission that the president was shot by a single assassin. The National Museum of Health and Medicine of the Armed Forces Institute of Pathology has the means of housing autopsy records, and should make them available to the public so that the speculation surrounding the incident will end.

Autopsy, Public opinion, Lincoln, Abraham, Kennedy, John F., Assassination

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The autopsy room

Article Abstract:

A night orderly working at an old men's lodge, studying to be a doctor, describes his experiences at the lodge. The orderly had befriended an 100-year-old man at the lodge who was suffering from old age and insomnia but could not manage to spend enough time with him.

United States, Psychological aspects, Personal narratives, Medical students, Aged patients, Elderly patients, Personal account

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