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Cytomegalovirus-Induced Pneumonia and Myocarditis in Three Cases of Suspected Sudden Infant Death Syndrome (SIDS): Diagnosis by Immunohistochemical Techniques and Molecularpathologic Methods

NCJ Number
222208
Journal
Forensic Science International Volume: 174 Issue: 2-3 Dated: January 2008 Pages: 229-233
Author(s)
Reinhard Dettmeyer; Jan P. Sperhake; Jutta Muller; Burkhard Madea
Date Published
January 2008
Length
5 pages
Annotation
This paper reports on three cases of the deaths of children younger than 1-year who died suddenly without any disease symptoms and were initially misdiagnosed as having died of sudden infant death syndrome (SIDS), only later to be determined to have died from cytometgalovirus-induced pneumonia and myocarditis based on diagnosis by immunohistochemical techniques and molecularpathologic methods.
Abstract
All babies were found in their beds. One was preterm born and found in prone position, body weight at autopsy 4600 g. The second one (body weight 5500g) was found in supine position, and resuscitation failed. In the third case, resuscitation also failed. The infant was found prone. None of the infants had shown any signs of illness prior to death. Their deaths were initially attributed to SIDS. In situ-hybridization, immunohistochemical (LCA, CD45R0, CD68, MHC-class-II-molecules, E-selectine) and molecularpathologic investigations (PCR), however, suggested that death was caused by a cytomegalovirus-induced pneumonia or myocarditis. Immunohistochemical and molecularpathologic techniques have improved the diagnosis of myocarditis compared with conventional histologic staining methods done according to the Dallas criteria. This paper recommends that these methods be used for investigating cases with suspicion of SIDS. 2 tables, 6 figures, and 21 references