Institute of Pathology, Academic Clinic München-Bogenhausen, Munich, Germany.
Department of Radiology, Ludwig-Maximilians University (LMU), Munich, Germany.
PLoS One. 2021 May 4;16(5):e0249955. doi: 10.1371/journal.pone.0249955. eCollection 2021.
In paleopathology, morphological and molecular evidence for infection by mycobacteria of the M. tuberculosis complex (MTC) is frequently associated with early death. In the present report, we describe a multidisciplinary study of a well-preserved mummy from Napoleonic times with a long-standing tuberculous infection by M. tuberculosis senso stricto who died at the age of 88 years of focal and non-MTB related bronchopneumonia. The well-preserved natural mummy of the Royal Bavarian General, Count Heinrich LII Reuss-Köstritz (1763-1851 CE), was extensively investigated by macro- and histomorphology, whole body CT scans and organ radiography, various molecular tissue analyses, including stable isotope analysis and molecular genetic tests. We identified signs for a long-standing, but terminally inactive pulmonary tuberculosis, tuberculous destruction of the second lumbar vertebral body, and a large tuberculous abscess in the right (retroperitoneal) psoas region (a cold abscess). This cold abscess harboured an active tuberculous infection as evidenced by histological and molecular tests. Radiological and histological analysis further revealed extensive arteriosclerosis with (non-obliterating) coronary and significant carotid arteriosclerosis, healthy bone tissue without evidence of age-related osteopenia, evidence for diffuse idiopathic skeletal hyperostosis and mild osteoarthrosis of few joints. This suggests excellent living conditions correlating well with his diet indicated by stable isotope results and literary evidence. Despite the clear evidence of a tuberculous cold abscess with bacterioscopic and molecular proof for a persisting MTC infection of a human-type M. tuberculosis strain, we can exclude the chronic MTC infection as cause of death. The detection of MTC in historic individuals should therefore be interpreted with great caution and include further data, such as their nutritional status.
在古病理学中，形态学和分子证据表明感染结核分枝杆菌复合群（MTC）的细菌常与早期死亡相关。在本报告中，我们描述了一项对一具保存完好的拿破仑时代木乃伊的多学科研究，该木乃伊患有长期的结核分枝杆菌（结核分枝杆菌狭义）感染，88 岁时死于局灶性和非 MTB 相关的支气管肺炎。对巴伐利亚皇家将军、海因里希二世·罗伊斯-科斯特里茨伯爵（1763-1851 年）的天然木乃伊进行了广泛的研究，包括宏观和组织形态学、全身 CT 扫描和器官射线照相、各种组织分子分析，包括稳定同位素分析和分子遗传学测试。我们发现了长期但终末期无活性的肺结核、第二腰椎结核破坏以及右（腹膜后）腰大肌区域的大结核脓肿（寒性脓肿）的迹象。组织学和分子检测证实了该寒性脓肿存在活动性结核感染。放射学和组织学分析进一步显示广泛的动脉粥样硬化，包括（非闭塞性）冠状动脉和显著的颈动脉粥样硬化、无年龄相关性骨质疏松证据的健康骨组织、弥漫性特发性骨肥厚和少数关节的轻度骨关节炎的证据。这表明他的生活条件极好，与稳定同位素结果和文学证据所表明的饮食情况相符。尽管有明确的证据表明存在结核寒性脓肿，并且细菌学和分子证据表明存在持续的人型结核分枝杆菌株 MTC 感染，但我们可以排除慢性 MTC 感染是死亡的原因。因此，在历史个体中检测到 MTC 时应谨慎解释，并包括进一步的数据，例如他们的营养状况。
