Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Services, Faculty of Health Science, Stellenbosch University, Tygerberg, South Africa.
Forensic Sci Int. 2011 Mar 20;206(1-3):e27-30. doi: 10.1016/j.forsciint.2010.07.018. Epub 2010 Aug 11.
The classification of an unexpected infant death as the sudden infant death syndrome (SIDS) depends upon a complete autopsy and death scene investigation to exclude known causes of death. Here we report the death of a 4-month-old infant in a tuberculosis endemic area that presented as a sudden unexpected death in infancy (SUDI) with no apparent explanation based on the death scene characteristics. The autopsy, however, revealed progressive primary pulmonary tuberculosis with intrathoracicadenopathy, compression of the tracheobronchial tree and miliary lesions in the liver. This case underscores the clinical difficulties in the diagnosis of infantile tuberculosis, as well as the possibility of sudden death as part of its protean manifestations. The pathology and clinical progression of tuberculosis in infants differ from older children and adults due to the immature immune response in infants. This case dramatically highlights the need for complete autopsies in all sudden and unexpected infant deaths, as well as the public health issues in a sentinel infant tuberculosis diagnosis.
婴儿猝死综合征（SIDS）的分类取决于完整的尸检和死亡现场调查，以排除已知的死亡原因。在这里，我们报告了一名 4 个月大的婴儿在结核病流行地区的死亡，该婴儿的死亡表现为无明显原因的婴儿突发意外死亡（SUDI）。然而，尸检显示原发性肺结核进行性进展，伴有胸腔内淋巴结病、气管支气管树受压和肝脏内粟粒状病变。该病例强调了婴儿结核病诊断的临床困难，以及其多变表现中突然死亡的可能性。由于婴儿的免疫反应不成熟，婴儿的结核病病理学和临床进展与年龄较大的儿童和成人不同。该病例突出强调了在所有突然和意外的婴儿死亡中进行全面尸检的必要性，以及在婴儿结核病的哨点诊断中的公共卫生问题。
