Diagnosis of lung infection in sudden adult death: Comparison of postmortem computed tomography and histopathology.

This study aimed at comparing two main existing diagnostic methods for the detection of lung infection in post-mortem cases of sudden adult death. Post-mortem computed tomography (PMCT) imaging of lungs and histopathology examination (HPE) of lung tissue were selected to compare their sensitivity and specificity. This retrospective case control study was conducted in a tertiary referral centre on 220 deceased individuals who underwent PMCT imaging prior to autopsy and had histology sampling during autopsy in the years 2016 - 2019. The bodies were examined with PMCT prior to conventional autopsy. Histology sampling were taken in those selected cases as part of medicolegal investigations. The reports and images of PMCT, and HPE reports with slides were retrieved and re-evaluated. Findings of PMCT and HPE were divided into pneumonia and non-pneumonia groups. Only PMCT images of chest and histology slides of lungs were accessed and evaluated. The result showed that the sensitivity and specificity of PMCT in the diagnosis of lung infection was 98.2% and 36.4%, whereas HPE showed a sensitivity and specificity of 97.3% and 100%. The accuracy of PMCT and HPE were 67.2 % and 98.6 % respectively. In conclusion, HPE had better accuracy compared to PMCT with almost similar sensitivity but higher specificity. PMCT may act as a good screening tool for pneumonia but is insufficient to substitute conventional autopsy in the diagnosis of pneumonia. Routine histology sampling during autopsy should be practised whenever dealing with sudden death.