Kruger Mia M, Martin Lorna J, Maistry Sairita, Heathfield Laura J
Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
Forensic Sci Int. 2018 Aug;289:108-119. doi: 10.1016/j.forsciint.2018.05.023. Epub 2018 May 21.
Death due to infectious diseases is a major health concern worldwide. This is of particular concern in developing countries where poor-socio economic status and a lack of healthcare resources contribute to the high burden of disease. In some cases death due to infection can be acute and aggressive, and death may occur without a diagnosis whilst the person is still alive. These deaths may ultimately lead to a medico-legal autopsy being performed. There are various mechanisms by which sudden death due to infection may occur. In addition, there are many risk factors associated with sudden death due to infection, which differ between infants and older individuals. However, it is unclear which pathogens and risk factors are most frequently associated with sudden death due to infection. Therefore a systematic review of articles and case reports published between 1 January 2000 and 30 June 2016 was undertaken in order to (1) explore the relationship between pathogens and their causative role and (2) identify the relationship between predisposing and/or risk factors associated with sudden death due to infection. Major databases were searched and after critical appraisal 143 articles were identified. It was found that respiratory infections and deaths involving bacterial pathogens were most commonly associated with these deaths. In addition the most common risk factors in infants were exposure to tobacco smoke and co-sleeping. In adults the most common risk factors were co-morbid conditions and illnesses. This information aids in a better understanding of these deaths and highlights the need for more research in this field, particularly in developing countries.
传染病导致的死亡是全球主要的健康问题。在发展中国家，这一问题尤为令人担忧，因为社会经济地位低下和医疗资源匮乏导致了疾病的高负担。在某些情况下，感染导致的死亡可能是急性且严重的，患者可能在仍存活时未被诊断就死亡了。这些死亡最终可能导致进行法医尸检。感染导致猝死的机制多种多样。此外，与感染导致猝死相关的危险因素有很多，婴儿和老年人之间存在差异。然而，尚不清楚哪些病原体和危险因素与感染导致的猝死最为相关。因此，对2000年1月1日至2016年6月30日期间发表的文章和病例报告进行了系统综述，以（1）探讨病原体与其致病作用之间的关系，以及（2）确定与感染导致猝死相关的易感因素和/或危险因素之间的关系。检索了主要数据库，经过严格评估后确定了143篇文章。研究发现，呼吸道感染和涉及细菌病原体的死亡与这些死亡最为相关。此外，婴儿最常见的危险因素是接触烟草烟雾和同床睡眠。在成年人中，最常见的危险因素是合并症和疾病。这些信息有助于更好地理解这些死亡情况，并凸显了在该领域，特别是在发展中国家进行更多研究的必要性。
