Otitis media observed in unexpected natural death of infants

Abstract

Intracranial complications due to otitis media such as brain abscess and leptomeningitis are well known as a cause of death. In recent years, encountering those serious intracranial complications in forensic medical practice is extremely rare. However, we rarely encounter autopsy cases with otitis media of which pathological damage is mild or moderate. We investigated 11 autopsy cases (6 cases of pneumonia and 5 cases of SIDS) in unexpected natural death of infants under one year old, and found 3 cases with otitis media. The tympanic cavity was investigated by chiseling a petrosal part of the base of the skull. In the case of otitis media, serous and mucous exudate containing leucocytes examined microscopically was observed. Otitis media, as such, was not a cause of death in our cases presented. Background factors causing otitis media seems to be not only functional insufficiency of the auditory tube but also other delicate constitution, hidden dysfunction or immature function in immune system, which could be easily infected. Of 3 cases of otitis media, cytomegalovirus infection was observed in 2 cases simultaneously. In our department, we have little opportunity to encounter autopsy cases of infant under one year old. If many infant cases could be investigated, many autopsy cases with otitis media might be encountered in unexpected infant deaths.