Sudden infant death due to asplenia syndrome

An apparently healthy 80-day-old boy died suddenly for no apparent reason. The autopsy revealed that the patient had had congenital asplenia, extensive cardiovascular anomalies, and other organ malformations, including trisegmented lungs, hypoplasia of the corpus callosum and cranial bones, a symmetrical liver, accessory hepatic tissue in the adrenal glands, malrotation of the intestine, and hypoplasia of the greater omentum.     

Sudden unexpected infant death due to fibroma of the heart

A 7-month-old previously healthy female infant was found dead in her crib by her mother shortly after having been laid down to sleep following the noontime feeding. Because the child did not suffer from an acute illness and no other evidence pointed to a cause of death, it was initially assumed by the police that she had died of sudden infant death syndrome. At autopsy, however, the cause of death was determined to be cardiac arrhythmia secondary to fibroma of the heart.     

Sudden infant death from atelectasis due to amniotic fluid aspiration

An infant girl, whose hands showed lobster-claw deformity, was found dead in her bed at 17 days of age. Macroscopic and microscopic examination of the lungs showed fatal atelectasis. The alveolar spaces were filled with fluid, epithelial cells, and squamous debris. These were the constituents of amniotic fluid aspirated before birth. The present case suggested that some sudden unexpected deaths in early infancy are delayed deaths caused by amniotic fluid aspiration.     

Sudden death due to streptococcal infection

Sudden unexpected deaths form a large population of medical examiner caseloads. Presented are the clinical, pathologic, and virulence features of sudden death due to Group A beta-hemolytic streptococcus. Emphasis is placed on the importance of post-mortem cultures. Case histories are included to illustrate the sometimes unusual presentation of this disease. Recent publicity has led to a heightened public awareness of this unusually virulent entity.     

心脏脂肪瘤猝死1例报告

心脏脂肪瘤是一种十分罕见的良性原发性心脏肿瘤.心脏脂肪瘤引起的猝死国内尚未见有报道.我们在法医检案中偶然遇见一例,现报告如下.     

心脏脂肪瘤猝死1例报告

心脏脂肪瘤是一种十分罕见的良性原发性心脏肿瘤。心脏脂肪瘤引起的猝死国内尚未见有报道。我们在法医检案中偶然遇见一例，现报告如下。死者杨某某，男，48岁，生前有心脏病史。因琐事与邻居发生纠纷，吵打中突然倒地，抢救无效死亡。解剖检验：厂长168cm，发育正常，营养中等。睑球结膜苍白，口唇、指甲青紫，口鼻部有多量血性液体流出。全身体表有数处轻微擦挫伤。右肺和胸壁、隔肌轻度粘连、心脏重369g，外形上常。心外膜光滑，心肌暗红色，有光泽，各瓣膜无异常。冠犬动脉畅，轻度粥样硬化。房间隔卵圆窝上部有-60mm×40mm×40mm肿瘤稍…     

Sudden death due to malignant hyperthermia

A case of sudden death in a young athlete, most likely the result of malignant hyperthermia, is reported. This diagnosis was entertained at autopsy and later confirmed by muscle biopsy on the father of the deceased, who was proven to be susceptible to malignant hyperthermia. The condition should be strongly suspected at autopsy in unexplained sudden deaths of young adults occurring during exercise or under stress.     

Sudden death due to diabetic ketoacidosis

Two obese women not known to be diabetic died suddenly of diabetic ketoacidosis (DKA). To our knowledge, sudden unexpected death due to DKA has not been reported as the only manifestation of diabetes mellitus. The investigation of sudden death in patients with risk factors for diabetes, especially in the absence of significant disease of the internal organs, should include determination of vitreous glucose and ketones.     

Sudden death due to lymphoplasmacytic hypophysitis.

We report the case of a 37-year-old mentally retarded woman who died suddenly with premortem clinical signs of diabetes insipidus. At autopsy, her pituitary was infiltrated and destroyed by a lymphoplasmacytic infiltrate, affecting the posterior pituitary more severely than the anterior pituitary. Vitreous electrolytes showed a pattern of hypertonic dehydration, compatible with diabetes insipidus.     

Sudden death due to right ventricular cardiomyopathy

A 21-year-old man died suddenly at a small party. He had had no clinical signs of cardiac disease except for a slightly abnormal electrocardiogram (occasional premature ventricular contractions) since he was 15 years of age. Autopsy examination revealed cardiomegaly (469 g), with right atrial and ventricular dilatation. The right ventricular myocardium was massively replaced with adipose tissue, and there was one isolated fatty lesion in the right side of the ventricular septum. There were no congenital malformations such as a septal defect or valvular deformity. Histologically, muscular fibers remaining in the right ventricular wall showed neither degenerative nor inflammatory changes. An isolated lesion of the ventricular septum consisted of almost complete replacement of the muscle bundles with adipose tissue. Such a pathologic condition has recently been termed right ventricular cardiomyopathy. Postmortem examination is necessary to make a definite diagnosis of the disease, because in most adult cases of the disease, sudden death occurs before there have been any critical signs.     

Sudden death due to undiagnosed intracranial hemangiopericytoma

A previously healthy 9-year-old Japanese boy with a 4-day history of vomiting and headache died suddenly and unexpectedly. An external examination revealed no abnormalities other than foam around the mouth and nose. An internal examination revealed severe pulmonary edema and hemorrhagic hemangiopericytoma arising from the choroid plexus of the right lateral ventricle. The cause of death was thought to be neurogenic pulmonary edema caused by the rapid growth of a hemangiopericytoma, with intratumoral hemorrhage.     

Sudden death due to thrombotic thrombocytopenic purpura

This case studies the clinical, laboratory, and pathologic findings observed in thrombotic thrombocytopenic purpura (TTP). Although TTP is a well-recognized syndrome, it is frequently undetected antemortem and represents a rare cause of sudden death. We recently were involved in a case of TTP in which an 18-year-old woman with no previous history died suddenly. The case was referred to our office for consultation because of a recent history of methamphetamine abuse. We report herewith our approach to the diagnostic workup of TTP and review relevant literature.     

Sudden infant death with periventricular leukomalacia

Periventricular leukomalacia (PVL) is a form of cerebral infarction occurring in neonates, particularly in low-weight and premature infants. PVL is well-known to neonatologists, but generally considered nonfatal. Many infants with PVL die in the hospital with multiple medical problems. Those infants with PVL who survive because of intensive care will have serious motor and sensory deficits, but these problems are rarely recognized before one year of age. When infants with PVL die at home, death seems sudden and unexpected. However, it is important to distinguish death caused by PVL from the Sudden Infant Death Syndrome because the implications for the family are quite different. This case report emphasizes that PVL may be fatal.     

Sudden infant death syndrome in Japan

Two autopsied cases are presented, one involving a 5-month-old infant, and a 6-month-old infant both of whom died suddenly and unexpectedly. The incidence of sudden infant death syndrome in Japan is 1.2 per 1,000 babies live births. Among all cases autopsied in the departments of legal or forensic medicine in 78 universities or colleges of Japan, the incidence was 15 (0.5%) per 3,329 in 1984 and 20 (0.6%) per 3,150 in 1985.     

Sudden death due to unsuspected coronary vasculitis.

Coronary artery vasculitis is a well-recognized complication of polyarteritis nodosa and is occasionally seen in other forms of systemic vasculitis. However, involvement of the major epicardial coronary arteries leading to myocardial infarction and death is uncommon. Isolated coronary arteritis is even more rare. We report three cases of sudden death due to myocardial ischemia associated with arteritis of the major coronary arteries. All three decedents were previously healthy young to middle-aged men who had died suddenly after complaints of chest pain and shortness of breath. The autopsy findings and differential diagnoses are presented. Such cases are of particular interest to the medical examiner because of the sudden, unexpected nature of the deaths. An approach to the correct diagnosis is discussed.     

Sudden death due to a laryngeal cyst.

A 68-year-old woman died suddenly at home; her body was found in an armchair in a sitting position. Autopsy revealed a laryngeal cyst of a dilated secretory gland, located above the vocal cords, which obstructed the glottis, causing asphyxia. A review of the literature with forensic implications is given.     

Sudden death due to primary diffuse leptomeningeal gliomatosis

Tumors of the central nervous system are an unusual cause of sudden death. This report describes the sudden death of a presumed healthy 28-year-old woman from primary diffuse leptomeningeal gliomatosis. She presented to an emergency room with headache and vomiting, subsequently became unresponsive and was pronounced dead 14 h later. Autopsy revealed a diffuse extensive infiltrate of well-differentiated astrocytoma in the leptomeninges of the brain and spinal cord without an underlying parenchymal tumor. Primary diffuse leptomeningeal gliomatosis is a rare tumor that arises within the leptomeninges from small neuroglial heterotopic rests that undergo neoplastic transformation. Grossly. this tumor can mimic leptomeningeal carcinomatosis, pachymeningitis, tuberculosis, sarcoidosis, and fungal infections. However, the histologic features of primary diffuse leptomeningeal gliomatosis should allow it to be readily distinguished from grossly similar conditions. The mechanism of death in this case is most likely tumor obstruction of cerebrospinal fluid outflow resulting in the usual complications seen with increased intracranial pressure. Although this tumor is aggressive and is associated with a rapidly progressive fatal course, it has not been previously associated with sudden death.