2018年5月
Sudden infant death with respiratory syncytial virus infection in which patent ductus arteriosus was suspected to involve: four autopsy case reports
The Japanese Journal of Legal Medicine
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- 巻
- 72
- 号
- 1
- 開始ページ
- 121
- 終了ページ
- 122
- 記述言語
- 英語
- 掲載種別
- 研究発表ペーパー・要旨（国際会議）
- 出版者・発行元
- (NPO)日本法医学会
【P-69】 24th Congress of the International Academy of Legal Medicine (IALM) ／ 第24回 国際法医学アカデミー ＠福岡国際会議場 (2018年6月5日〜8日) ［ポスター発表］
Background:
We encountered four autopsy cases of sudden infant death with mild respiratory syncytial virus (RSV) infection in which patent ductus arteriosus (PDA) was suspected to involve.
Materials and Methods:
Case 1 was a 16-day-old male infant. He caught a cold and completely recovered. Five days after catching the cold, several hours after a night cry, he was found unresponsive. Case 2 was a 7-week-old female infant, case 3 was a 5-week-old female infant, and case 4 was a 3-month-old female infant. In these three cases, several hours after a night cry, she was found unresponsive. Case 1, 2 and 4 were normal birth and development. Case 3 was born by vacuum extraction without other remarkable growth history.
Results:
In all cases, PDAs were recognized on autopsy, which had been asymptomatic and clinically undiagnosed (silent PDA). Because the lungs showed a tendency to sink with a hydrostatic lung test and inflammatory changes such as lymphocytic infiltration mainly into the bronchioles by a histopathological examination, we diagnosed that bronchial pneumonia (in case 1 and 2) or bronchiolitis (in case 3 and 4) was the direct cause of death. However, changes of the lung lesions were considered too mild to fully account for the speed and prime cause of death, and reactions to RSV tests were faint.
Conclusions:
Therefore, we concluded that persistent cardiac load or some kind of circulatory stress from the comorbid PDA was eventually involved in the process of sudden death in these cases. PDA is a rather common cardiovascular malformation, and numbers of infants with PDA may develop normally. Since detection of PDA has been difficult, especially in asymptomatic case, and even silent PDA can lead to sudden infant death with complications such as RSV infection, we emphasize the importance of paying attention to the probability of undiagnosed PDA in forensic autopsy on sudden infant death cases.
Background:
We encountered four autopsy cases of sudden infant death with mild respiratory syncytial virus (RSV) infection in which patent ductus arteriosus (PDA) was suspected to involve.
Materials and Methods:
Case 1 was a 16-day-old male infant. He caught a cold and completely recovered. Five days after catching the cold, several hours after a night cry, he was found unresponsive. Case 2 was a 7-week-old female infant, case 3 was a 5-week-old female infant, and case 4 was a 3-month-old female infant. In these three cases, several hours after a night cry, she was found unresponsive. Case 1, 2 and 4 were normal birth and development. Case 3 was born by vacuum extraction without other remarkable growth history.
Results:
In all cases, PDAs were recognized on autopsy, which had been asymptomatic and clinically undiagnosed (silent PDA). Because the lungs showed a tendency to sink with a hydrostatic lung test and inflammatory changes such as lymphocytic infiltration mainly into the bronchioles by a histopathological examination, we diagnosed that bronchial pneumonia (in case 1 and 2) or bronchiolitis (in case 3 and 4) was the direct cause of death. However, changes of the lung lesions were considered too mild to fully account for the speed and prime cause of death, and reactions to RSV tests were faint.
Conclusions:
Therefore, we concluded that persistent cardiac load or some kind of circulatory stress from the comorbid PDA was eventually involved in the process of sudden death in these cases. PDA is a rather common cardiovascular malformation, and numbers of infants with PDA may develop normally. Since detection of PDA has been difficult, especially in asymptomatic case, and even silent PDA can lead to sudden infant death with complications such as RSV infection, we emphasize the importance of paying attention to the probability of undiagnosed PDA in forensic autopsy on sudden infant death cases.
- ID情報
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- ISSN : 0047-1887
- 医中誌Web ID : S521270163