1/5. Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death.infant and early childhood death caused by environmental hyperthermia (fatal heat stroke) is a rare event, typically occurring in vehicles or beds. The aims of this study were to describe the demographics, circumstances, pathology, and manner of death in infants and young children who died of environmental hyperthermia and to compare these cases with those reported in the literature. Scene investigation, autopsy reports, and the microscopic slides of cases from three jurisdictions were reviewed. The subjects in 10 identified cases ranged in age from 53 days to 9 years. Eight were discovered in vehicles and 2 in beds. When the authors' cases were grouped with reported cases, the profile of those in vehicles differed from those in beds. The former were older, were exposed to rapidly reached higher temperatures, and often had more severe skin damage. The latter were mostly infants and were exposed to lower environmental temperatures. Hepatocellular necrosis and disseminated intravascular coagulation were reported in victims who survived at least 6 hours after the hyperthermic exposure. The consistent postmortem finding among nearly all victims was intrathoracic petechiae, suggesting terminal gasping in an attempt at autoresuscitation before death. The manner of death was either accident or homicide. Recommendations for the scene investigation are made.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
2/5. dehydration and heat-related death: sweat lodge syndrome.A 37-year-old Caucasian male died of dehydration and heat exposure following a sweat lodge ceremony in outback australia. The case demonstrates difficulties that may arise in the determination of the cause of death at autopsy due to nonspecific pathologic findings in hyperthermic deaths. There are also a number of features that characterize this particular "sweat lodge syndrome," including prolonged exposure to elevated temperatures in a relatively uncontrolled environment, failure to ensure adequate hydration, failure to appreciate the significance of loss of consciousness, use of ineffective alternative methods of treatment, and delay in seeking appropriate medical care. Unfortunately, the adoption of rituals and practice from other cultures may not be a completely safe undertaking. Participants in this type of activity must be cognizant of the types of medical problems that may arise. Individuals with significant cardiovascular disease, those who are taking certain medications that predispose to hyperthermia, or those who have had large amounts of alcohol should not enter sweat lodges.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
3/5. Fatal rotavirus gastroenteritis: an analysis of 21 cases.During the period of May 1972 to March 1977, twenty-one fatal cases of rotavirus acute gastroenteritis were recorded in the city of Toronto. The mean age of these subjects was approximately 1 year. Boys outnumbered girls by 12 to 9. Death occurred within three days of onset of symptoms in all cases. Sixteen of the subjects were profoundly dehydrated and had sodium levels (serum or vitreous humor) in excess of 150 mEq/liter. In 11 subjects, sodium values were greater than 160 mEq/liter. Although a physician was contacted in 16 instances, these infants still perished. We suggest that both language difficulties and the rapid rate of fluid depletion contributed significantly to the fatal outcome. At autopsy the bowel was often dilated and filled with fluid. Postmortem autolysis precluded an accurate histological assessment of the small bowel mucosa.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |
4/5. Uncommon extensive juxtacortical necrosis of the brain.A previously healthy woman in middle age, vacationing in spain, is treated with a massive dose of insulin for minimal hyperglycemia following an apparent gastrointestinal disease. This results in rapid coma and, 20 days later, in death. At autopsy, the main finding consists in a remarkable and uncommon ribbon-like juxtacortical necrosis of the white matter in both hemispheres of the telencephalon. There is also a microscopic focal necrosis in the pons cerebri. The grey matter of cortex and basal nuclei, and the subcortical arcuate fibers are spared. The detailed autopsy fails to reveal other essential changes. We have not been able to find reports on an identical case. Hypoglycemic coma usually causes cerebral lesions different from those seen in the present case. A brief analysis of the differential diagnosis is made. In the absence of unequivocal signs of infection, vascular disease or degenerative marks, the findings are tentatively related to complex interactions between fluid loss, hypoglycemic coma, hypoxia and other metabolic disturbances.- - - - - - - - - - ranking = 2keywords = autopsy (Clic here for more details about this article) |
5/5. Fatal hypernatremic dehydration in exclusively breast-fed newborn infants due to maternal lactation failure.Infants who die of hypernatremic dehydration usually demonstrate at autopsy an underlying condition or disease process that predisposes to increased water loss. In the absence of such findings, forensic concerns may focus sharply on parental or caretaker neglect as an underlying cause of death. In this case report, we describe unrecognized fatal hypernatremic dehydration in two exclusively breast-fed neonates due solely to failure of maternal lactation. We further describe epidemiologic and etiologic features of such deaths and discuss forensic difficulties encountered in their certification.- - - - - - - - - - ranking = 1keywords = autopsy (Clic here for more details about this article) |