Chapter 4 - An unfortunate family: an infant death by a rare disease

Abstract

The death of an infant, especially outside hospital or medical settings, immediately raises questions, if not patent suspicions, about child abuse. If child abuse is excluded, the differential diagnosis between sudden infant death syndrome (SIDS) and a huge number of congenital or acquired diseases might prove critically challenging for the pathologist. In this chapter, a case is presented where the overall circumstances could suggest child abuse, SIDS and/or medical malpractice. The post mortem clinical diagnosis, which led to assess the cause of death as natural by desquamative interstitial pneumonia (DIP), was achieved by histology. Medical malpractice was ruled out in conjunction with reference to an accurate analysis of hospital records. It is crucial and morally mandatory for both pathologists and law enforcement to remember that misdiagnoses/overdiagnoses in similar cases might hold dire and long lasting familiar, social and legal consequences.