Dauger Stéphane, Le Goff Jerome, Deho Anna, Jones Peter
PICU (SMUR) Réanimation Pédiatrique, Assistance Publique - Hôpitaux de Paris, Hôpital Robert Debré, Paris, France.
Service de Virologie, Assistance Publique, Hopitaux de Paris, Virologie, Hôpital St. Louis, Paris, France.
BMJ Case Rep. 2018 Nov 28;11(1):e227034. doi: 10.1136/bcr-2018-227034.
A 2-month-old girl with normal development and no previous physical illnesses was resuscitated having been found lifeless on her back at home. On admission to Paediatric Intensive Care, she had severe metabolic disturbance, associated with an extremely troubling neurological signs. She died 2 hours later. A full body CT scan did not reveal injury and her parents declined an autopsy. Peripheral blood and cerebrospinal fluid samples were sterile. However, a broad-range PCR coupled with electrospray-ionisation mass spectrometry onto the PLEX-ID automat of peripheral blood revealed the presence of varicella zoster virus. There was a specific viral load in whole blood of 20 542 copies/ml. It is presumed that Varicella myocarditis was the likely cause of death. Our case illustrates the potential usefulness of a broad range PCR strategy in determining infectious causes of death in sudden infant death. Varicella is a potential cause of sudden infant death.
一名2个月大发育正常且此前无身体疾病的女婴,在家中被发现仰卧无生命迹象后经抢救复苏。入住儿科重症监护病房时,她出现严重代谢紊乱,并伴有极其令人担忧的神经体征。2小时后死亡。全身CT扫描未发现损伤,其父母拒绝尸检。外周血和脑脊液样本无菌。然而,在外周血的PLEX-ID自动分析仪上进行的广谱聚合酶链反应(PCR)结合电喷雾电离质谱分析显示存在水痘带状疱疹病毒。全血中的病毒载量为20542拷贝/毫升。据推测,水痘心肌炎可能是死因。我们的病例说明了广谱PCR策略在确定婴儿猝死感染原因方面的潜在用途。水痘是婴儿猝死的一个潜在原因。