RT Journal Article SR Electronic T1 Mycobacterium tuberculosis: a continuing cause of sudden and unexpected death in west London. JF Journal of Clinical Pathology JO J Clin Pathol FD BMJ Publishing Group Ltd and Association of Clinical Pathologists SP 713 OP 715 DO 10.1136/jcp.45.8.713 VO 45 IS 8 A1 R C Chapman A1 S M Claydon YR 1992 UL http://jcp.bmj.com/content/45/8/713.abstract AB AIMS: To describe the pathological and background features of several cases of tuberculosis diagnosed at post mortem examinations and performed on behalf of HM Coroner over a three year period in west London. METHODS: Postmortem examinations were carried out by two pathologists working at hospital and public mortuaries in west London. Cases of tuberculosis were provisionally diagnosed on gross examination and the diagnosis confirmed on haematoxylin and eosin and Ziehl-Neelsen staining of retained tissues. The background information was obtained by scrutinising hospital records and by direct enquiry to general practitioners by coroners' officers. RESULTS: Thirteen cases of pulmonary tuberculosis were diagnosed during the period. No other cause of death was found. The incidence of fatal pulmonary tuberculosis was 0.28% of coroners' necropsies in the study region. Cases had been referred to the coroner because death had occurred unexpectedly, or because no recent medical attention had been sought. Most cases arose among the elderly Asian immigrant population or the homeless or the alcoholic, or both. In 10 cases the macroscopic findings strongly indicated pulmonary tuberculosis and in the other three the diagnosis was considered to be a differential diagnosis. CONCLUSIONS: These findings have important health implications for those carrying out post mortem examinations from these groups as well as for those involved with the continuing care of immigrant or vagrant populations.