The role of Coxsackievirus A16 in a case of sudden unexplained death in an infant – A SUDI case. (February 2016)

• Record Type: Journal Article
• Authors: Astrup, B.S.; Johnsen, I.B.G.; Engsbro, A.L.
• Is Part Of: Forensic science international. Volume 259(2016)
• Page Start: e9
• Page End: e13
• Publication Date: 2016-02
• Subjects: Sudden infant death -- Coxsackievirus -- Post-mortem radiology -- C-reactive protein -- CRP; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2015.12.017
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: The presented case shows the importance of supplementary autopsy techniques. In SUDI cases both the mode and the manner of death are important factors. Low virulence viruses should also be considered in child deaths. Abstract: The Coxsackievirus A16 (CV-A16) is one of the main pathogens causing hand-foot-and-mouth disease in young children. It is a low-virulence virus rarely involved in serious illness. It is seen sporadically or in outbreaks all over the world. We report a case of sudden unexplained death in infancy, SUDI, in a 3 and 1/2 months old infant, in which a thorough post mortem investigation pointed at a fatal infection with CV-A16 as the most likely cause of death. Only five cases of fatal CV-A16 infection have been published and none of these presented as sudden death. The fatal cases involved two infants, two young children and an elderly man. Post mortem, pre-autopsy CT-scan and C-reactive protein analysis allowed for an autopsy procedure targeted at a microbiological cause of death. The case illustrates the usefulness of supplementary testing during autopsy.