Unexpected death in early life

Abstract

<h2>Summary</h2> An adequate cause of death has been demonstrated in eighty-five of 103 infants and children who either were dead at the time of arrival in the hospital or died within twenty-four hours after admission; only ten in the entire group can be considered as sudden, unexpected deaths occurring in previously healthy infants. Infections were the leading cause of death, being responsible for forty-two of the 103 deaths; minor infections, such as otitis media or minimal pneumonic processes, were not considered an adequate explanation of the death of an infant or child. The importance of obtaining post-mortem cultures of the blood of infants who die suddenly and unexpectedly is emphasized, and the significance of the presence of different types of microorganisms in post-mortem cultures of the blood is discussed. Congenital malformations, involving especially the heart, were responsible for eighteen of the 103 deaths. In over one-half of these patients the presence of a congenital malformation had been recognized for some time prior to death. Mild cellular infiltrates in the interalveolar septa were not included as a cause of death, nor was aspiration of gastric contents into the trachea. There was no evidence that any of the infants died as a result of suffocation. It is suggested that the term "status thymicolymphaticus" might better be omitted from medical writings.