ISSN: 0022-1198
CODEN: JFSCA
Published Online: 1 November 2003
Page Count: 2

Meningitis Following Gunshot Wound of the Neck
(Received 24 June 2003; accepted 15 June 2003)

Abstract

It is generally assumed that a missile fired from a gun is subjected to sufficient heat to render it sterilized (1,2). For this reason, retained bullets are not usually considered a source of infection. The infectious complications associated with gunshot wounds are typically attributed to perforation of a hollow viscus with leakage of gastrointestinal contents causing peritonitis or intra-abdominal abscess. There are several reports of bacterial meningitis involving the spinal cord in gunshot wounds that perforate the intestine prior to involving the thoracic or lumbar vertebral column (3–6); however, there are no published reports of cerebral meningitis resulting from a retained projectile in the spinal canal in which there was no injury to the gastrointestinal tract. This manuscript describes a woman who died as a result of unsuspected acute bacterial meningitis which developed secondary to a gunshot wound of the neck. The projectile fractured the first thoracic vertebra, lacerated the dura and contused the spinal cord at the C7-T1 junction. Meningitis developed at the C7-T1 level and ascended along the cervical spinal cord to the brain. The infection caused acute neurologic deterioration and death four days following the initial injury.

Keywords:
forensic science, gunshot wounds, meningitis, infection, spinal cord, brain death

Paper ID: JFS2003133
DOI: 10.1520/JFS2003133
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