A newly-born infant is found dead in a latrine with signs of live birth (well-inflated pink lungs that float on water and submerge when compressed — positive hydrostatic test). The umbilical cord is torn, and there are multiple bruises on the head. The most likely finding in the LUNGS to indicate the infant breathed air postnatally (in addition to the hydrostatic test) is:

• A Microscopically aerated alveoli with flattened epithelium ✓
• B Presence of meconium in alveoli
• C Alveolar capillary engorgement with extravasated red cells
• D Consolidation of lung parenchyma

Explanation

In an infant that has breathed, the alveoli are microscopically expanded with thinned, flattened cuboidal epithelium, and the alveolar capillaries are patent. The overall histologic architecture shows uniformly inflated air spaces corresponding to the grossly floated lungs on hydrostatic testing. Meconium in alveoli indicates intrauterine hypoxic defecation and aspiration but does not confirm postnatal survival. Alveolar capillary engorgement is a non-specific congestion pattern. Consolidation indicates infection/pneumonia, not aeration per se. The histological confirmation of aerated alveoli with flattened epithelium is the microscopic correlate of the positive hydrostatic test.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.