Influenza A/H1N1 (2009) Infection as a Cause of Unexpected Out‐of‐Hospital Death in the Young* |
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Authors: | Camille Boulagnon M.D. B.S. Nicolas Leveque Pharm.D. Ph.D. Fanny Renois Ph.D. Laurent Andreoletti Pharm.D. Ph.D. Paul Fornes M.D. Ph.D. |
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Affiliation: | 1. Department of Pathology, Academic Hospital, 45 rue Cognac Jay, Reims, France.;2. Department of Medical and Molecular Virology, Academic Hospital and EA4303 Medicine Faculty of Reims, 45 rue Cognac Jay, Reims, France. |
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Abstract: | Abstract: In March 2009, a new strain of influenza A/H1N1 virus was identified in Mexico, responsible for a pandemic. Worldwide, more than 13,500 patients died, most often from acute respiratory distress syndrome. Because sudden death cases were rare, involving mostly young apparently healthy persons, influenza A/H1N1 (2009)‐related deaths may be misdiagnosed, which can raise medico‐legal issues. Case history: we report on an unexpected out‐of‐hospital death involving a young male with no past medical history and no vaccination. Fever was his only symptom. Laboratory tests: histology showed patchy necrotic foci with mononuclear inflammation in the lungs. The heart was histologically normal, but virological analyses using molecular biology on frozen myocardial samples showed high virus load. In conclusion, this case report shows that influenza A/H1N1 (2009) virus can be a cause of sudden cardiac death in the young and demonstrates the importance of quantitative virological analyses for the diagnosis of myocarditis. |
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Keywords: | forensic science forensic pathology autopsy influenza A pandemic sudden unexplained death virology myocarditis postmortem |
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