NCJ Number
203516
Journal
Journal of Forensic Sciences Volume: 48 Issue: 6 Dated: November 2003 Pages: 1369-1370
Date Published
November 2003
Length
2 pages
Annotation
This article discusses the case study of a woman that died as a result of meningitis following being shot in the neck.
Abstract
A 36-year-old woman was the victim of an apparent attempted murder-suicide. She was found to have a single gunshot wound to the left side of the neck at the top of the shoulder. On the third day after admission to the hospital, she developed acute mental status changes, respiratory distress, and bradycardia. She became unconscious and was subsequently pronounced dead the following day. The autopsy demonstrated acute bacterial meningitis. Gunshot wounds are the third most common cause of traumatic spinal cord injury in the United States, but they are a rare cause of central nervous system (CNS) infection. The idea of bullet autosterilization upon discharge from a weapon has been conclusively disproven, making the previous belief that bullets cause antiseptic wounds inaccurate. Bullets should not be considered sterile for several reasons. The heat generated as a bullet is propelled from the muzzle of a gun is of insufficient intensity and duration to cause complete sterilization. When the bullet courses through clothing, skin or hair, microorganisms including normal skin and hair flora are readily introduced into the wound. Most reported cases of gunshot wounds associated with meningitis involve intra-abdominal wounds that perforate the colon or small intestine in addition to the vertebral column. In this case, the source of infection was the fragmented bullet that was subject to bacterial contamination as it perforated the skin. The close time proximity between the gunshot wound and the death makes for an obvious direct cause and effect relationship between the meningitis and the retained bullet. Conclusions drawn from this case include: (1) bullets are not sterile and should always be considered as a possible source of infection; and (2) bullet fragments retained in the spinal canal may be a source of central nervous system infection. 1 figure, 10 references