Primeira autópsia do sistema nervoso central no sul do Brasil

A história da Anatomia Patológica no Estado do Paraná, sul do Brasil, está ligada com a fundação da Universidade Federal do Paraná (UFPR). Este estudo identificou a primeira autópsia clínica do sistema nervoso central (SNC) realizada pelo Departamento de Anatomia Patológica da UFPR.

Métodos:

Foi realizada revisão dos arquivos dos relatórios de autópsia do HC-UFPR, desde 1951. As interpretações anátomo-clínicas do laudo da autópsia e os possíveis agentes etiológicos foram discutidas.

Resultado:

A primeira autópsia clínica em adulto com estudo do SNC foi realizada em 23 de abril de 1952. Um homem de 45 anos com pneumonia lobar com abscessos pulmonares, complicada com meningite bacteriana.

Conclusão:

Este caso é a primeira autópsia clínica em adulto com estudo do SNC do estado do Paraná e possivelmente do Sul do Brasil. A causa da morte foi devido a uma doença infecciosa, as principais causas de óbito no Brasil nos anos 50.

Palavras-chave:
Meningite; autópsia; sistema nervoso central; pneumonia; abscesso pulmonar

Autoria

Sérgio Monteiro de Almeida Correspondence: Sérgio Monteiro de Almeida; Hospital de Clínicas – UFPR, Seção de Virologia, Setor Análises Clínicas; Rua Padre Camargo, 280; 80060-240 Curitiba PR, Brasil; E-mail: sergio.ma@ufpr.br

Departamento de Patologia Médica, Universidade Federal do Paraná, Curitiba PR, Brasil;Universidade Federal do ParanáBrasilCuritiba, PR, BrasilDepartamento de Patologia Médica, Universidade Federal do Paraná, Curitiba PR, Brasil;

Faculdades Pequeno Príncipe, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba PR, BrasilInstituto de Pesquisa Pelé Pequeno PríncipeBrasilCuritiba, PR, BrasilFaculdades Pequeno Príncipe, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba PR, Brasil

http://orcid.org/0000-0001-5690-105X

Gabriel L.O. Salvador

Thiago H. Roza

Lucia Noronha

Luiz Fernando Bleggi Torres

Correspondence: Sérgio Monteiro de Almeida; Hospital de Clínicas – UFPR, Seção de Virologia, Setor Análises Clínicas; Rua Padre Camargo, 280; 80060-240 Curitiba PR, Brasil; E-mail: sergio.ma@ufpr.br

Conflict of interest: There is no conflict of interest to declare.

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Figuras

Figuras (4)

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Figure 1
The first clinical autopsy performed by the Department of Anatomical Pathology of the School of Medicine of the UFPR, was performed on November 18, 1951, on a 32-year-old white widowed woman. The cause of death was pulmonary tuberculosis. The pathologist who signed was Prof. Dr. Ruy Leal. According to the World Health Organization, tuberculosis, while no longer among the 10 leading causes of death, still remained among the 15 leading causes worldwide in 2012⁹9. World Health Organization – WHO. The top 10 causes of death Fact sheet N°310 Updated May 2014 [cited 2015 Mar 9]. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/
http://www.who.int/mediacentre/factsheet... .

Thumbnail

Figure 2
The first adult CNS clinical autopsy report, autopsy no. 70, was performed on April 23, 1952. The cause of death was acute purulent meningitis associated with lobar pneumonia with abscesses. The pathologist who signed was Prof. Dr. Ruy Leal.

Thumbnail

Figure 3
Clinical anatomical interpretations of the autopsy report and possible etiologic agents. We do not have the clinical history of the patient to best interpret the autopsy report, so this is a speculative discussion. A. Interpretation considered at the time, by Dr. Ruy Leal, as lobar pneumonia complicated by lung abscesses followed by meningitis; the main causes of lung abscesses are anaerobic bacteria, complicated by meningitis. B. Another probable interpretation, communitarian bacterial meningitis caused by Streptococcus pneumoniae, based on the patient's age, complicated by impaired consciousness and aspiration pneumonia with abscesses. C. S. pneumoniae pneumonia, the main etiologic agent of lobar pneumonia, complicated by lung abscesses; followed by sepsis and dissemination of S. pneumoniae to the brain, and meningitis. This hypothesis is less probable. S. pneumoniae, as a cause of lung abscess occurs in only 1%⁵5. Bartlett JG. Anaerobic bacterial infections of the lung. Chest. 1987 Jun;91(6):901-9. https://doi.Org/10.1378/chest.91.6.901
https://doi.Org/10.1378/chest.91.6.901... .

Thumbnail

Figure 4
Proportional mortality according to causes among capital cities in Brazil, 1930-1999 (modified from Carmo et al.⁸8. Carmo EH, Barreto ML, Silva Junior JB. Mudanças nos padrões de morbimortalidade da população brasileira: os desafios para um novo século. Epidemiol Serv Saúde. 2003;12:63-75.).

Figure 1 The first clinical autopsy performed by the Department of Anatomical Pathology of the School of Medicine of the UFPR, was performed on November 18, 1951, on a 32-year-old white widowed woman. The cause of death was pulmonary tuberculosis. The pathologist who signed was Prof. Dr. Ruy Leal. According to the World Health Organization, tuberculosis, while no longer among the 10 leading causes of death, still remained among the 15 leading causes worldwide in 2012⁹9. World Health Organization – WHO. The top 10 causes of death Fact sheet N°310 Updated May 2014 [cited 2015 Mar 9]. Available from: http://www.who.int/mediacentre/factsheets/fs310/en/
http://www.who.int/mediacentre/factsheet... .

Figure 2 The first adult CNS clinical autopsy report, autopsy no. 70, was performed on April 23, 1952. The cause of death was acute purulent meningitis associated with lobar pneumonia with abscesses. The pathologist who signed was Prof. Dr. Ruy Leal.

Figure 3 Clinical anatomical interpretations of the autopsy report and possible etiologic agents. We do not have the clinical history of the patient to best interpret the autopsy report, so this is a speculative discussion. A. Interpretation considered at the time, by Dr. Ruy Leal, as lobar pneumonia complicated by lung abscesses followed by meningitis; the main causes of lung abscesses are anaerobic bacteria, complicated by meningitis. B. Another probable interpretation, communitarian bacterial meningitis caused by Streptococcus pneumoniae, based on the patient's age, complicated by impaired consciousness and aspiration pneumonia with abscesses. C. S. pneumoniae pneumonia, the main etiologic agent of lobar pneumonia, complicated by lung abscesses; followed by sepsis and dissemination of S. pneumoniae to the brain, and meningitis. This hypothesis is less probable. S. pneumoniae, as a cause of lung abscess occurs in only 1%⁵5. Bartlett JG. Anaerobic bacterial infections of the lung. Chest. 1987 Jun;91(6):901-9. https://doi.Org/10.1378/chest.91.6.901
https://doi.Org/10.1378/chest.91.6.901... .

Figure 4 Proportional mortality according to causes among capital cities in Brazil, 1930-1999 (modified from Carmo et al.⁸8. Carmo EH, Barreto ML, Silva Junior JB. Mudanças nos padrões de morbimortalidade da população brasileira: os desafios para um novo século. Epidemiol Serv Saúde. 2003;12:63-75.).

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Primeira autópsia do sistema nervoso central no sul do Brasil

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[1] Correspondence: Sérgio Monteiro de Almeida; Hospital de Clínicas – UFPR, Seção de Virologia, Setor Análises Clínicas; Rua Padre Camargo, 280; 80060-240 Curitiba PR, Brasil; E-mail: sergio.ma@ufpr.br