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Intrathoracic petechial hemorrhages in sudden infant death syndrome and other infant deaths: time for re-examination.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Goldwater, Paul N.
Spatial Coverage	South Australia
Description	Country affiliation: Australia Author Affiliation: Goldwater PN ( Microbiology & Infectious Diseases Department, the Women's & Children's Hospital, Discipline of Paediatrics, Children, Youth & Women's Health Service, North Adelaide, South Australia 5006, Australia. paul.goldwater@cywhs.sa.gov.au)
Abstract	The objective of this study was to provide a predictive tool to assist forensic and pediatric pathologists in the diagnosis of sudden unexpected infant death and to discuss the pathogenesis of intrathoracic petechial hemorrhages through a retrospective autopsy report review of 174 sudden infant death syndrome (SIDS) cases (2004 definition) and 67 age-matched comparison deaths. The setting was a qualitative assessment (presence or absence) of macroscopic intrathoracic petechiae in SIDS and age-matched comparison of sudden unexpected deaths that occurred in the late 1980s and early 1990s. Sensitivity, specificity, and positive and negative predictive values for thymic, pleural, and epicardial petechial hemorrhages were developed. Results showed 89.5%, 80%, and 79.9% SIDS (<12 months of age) had thymic, pleural, and epicardial petechiae, respectively, compared with 47.6%, 47.5% and 43.6% in non-SIDS deaths, respectively. Respective odds ratios were: 9.4 (4.5 to 19.9), 4.6 (2.3 to 9.1), 5.3 (2.6 to 10.8). When all 3 intrathoracic organ sites contain macroscopic petechiae, this is 84.9% predictive of SIDS; when all 3 sites have no detectable petechiae this is 93.1% predictive of a non-SIDS diagnosis. Thus, we conclude that careful assessment of intrathoracic petechiae at autopsy is likely to be diagnostically useful in the assessment of sudden unexplained infant death.
File Format	HTM / HTML
ISSN	10935266
Issue Number	6
Volume Number	11
e-ISSN	16155742
Journal	Pediatric and Developmental Pathology
Language	English
Publisher	Sage Publication
Publisher Date	2008-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pathology Discipline Pediatrics Cause Of Death Hemothorax Diagnosis Purpura Sudden Infant Death Diagnosis, Differential Epidemiology Humans Infant Infant, Newborn Odds Ratio Predictive Value Of Tests Retrospective Studies South Australia Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Pathology and Forensic Medicine Pediatrics, Perinatology and Child Health

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