Post-traumatic meningitis: histomorphological findings, postmortem microbiology and forensic implications

Infections of the leptomeninges with the infectious agent gaining access to the intracranial compartment by traumatic means are termed post-traumatic. In cases with fatal outcome, the manner of death has to be classified as non-natural. Six cases of post-traumatic meningitis as the cause of death from the archives of the Institute of Legal Medicine in Hamburg, Germany with histological and microbiological investigations are presented. There were all males, age varying between 24 and 90 years (mean 58 years); range of the interval between original trauma and beginning of symptoms was 2 days up to 8 years; in 50% of the cases meningeal swabs yielded Streptococcus pneumoniae. Findings concerning origin and mechanism of post-traumatic meningitis as well as microbiological studies are compared with selected cases from the literature.