Progressive primary pulmonary tuberculosis presenting as the sudden unexpected death in infancy: A case report

Abstract The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy and death scene investigation to exclude known causes of death. Here we report the death of a 4-month-old infant in a tuberculosis endemic area that presented as a sud...

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Bibliographic Details
Published in:Forensic science international 2011-03, Vol.206 (1), p.e27-e30
Main Authors: Dempers, Johan, Sens, Mary Ann, Wadee, Shabbir Ahmed, Kinney, Hannah C, Odendaal, Hein J, Wright, Colleen A
Format: Article
Language:English
Subjects:
Airway obstruction
Autopsies
Autopsy
Babies
Endemic Diseases
Forensic pathology
Forensic sciences
Humans
Infant
Liver - pathology
Lung - pathology
Male
Medical diagnosis
Mycobacterium
Pathology
Public health
SIDS
South Africa
Sudden Infant Death - etiology
Sudden infant death syndrome
Sudden infant death syndrome (SIDS)
Sudden unexplained death in infancy (SUDI)
Sudis
Tuberculosis
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - epidemiology
Tuberculosis, Pulmonary - transmission
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Summary:Abstract The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy and death scene investigation to exclude known causes of death. Here we report the death of a 4-month-old infant in a tuberculosis endemic area that presented as a sudden unexpected death in infancy (SUDI) with no apparent explanation based on the death scene characteristics. The autopsy, however, revealed progressive primary pulmonary tuberculosis with intrathoracicadenopathy, compression of the tracheobronchial tree and miliary lesions in the liver. This case underscores the clinical difficulties in the diagnosis of infantile tuberculosis, as well as the possibility of sudden death as part of its protean manifestations. The pathology and clinical progression of tuberculosis in infants differ from older children and adults due to the immature immune response in infants. This case dramatically highlights the need for complete autopsies in all sudden and unexpected infant deaths, as well as the public health issues in a sentinel infant tuberculosis diagnosis.
ISSN:0379-0738
1872-6283
DOI:10.1016/j.forsciint.2010.07.018