title: Dehydration deaths in infants and young children.
abstract: Dehydration in developed countries is an uncommon but important mechanism resulting in the death of infants and children. The clinicopathological features of a series of 37 fatal dehydration cases autopsied at the Adelaide Children's Hospital over a 33-year period (1961-1993) are presented. Causative factors for dehydration included gastroenteritis (21 cases), gastroenteritis with high environmental temperature (one case), high environmental temperatures (six cases), neglect/failure to thrive (four cases), mental retardation/chromosomal abnormality (three cases), congenital adrenal hyperplasia (one case), and unsuspected cystic fibrosis (one case). The mean age at death was 11.4 months (range 2 weeks to 6.25 years; median 6 months; 95% confidence interval 6 months to 1 year and 4 months; male-to-female ratio, 19:18). Sixteen of the 22 cases of fatal gastroenteritis (73%) occurred during the fall/winter months (March to August). There were a total of seven aboriginal or part aboriginal children in the group (19%). Children with mental retardation were at higher risk of dehydration, and previously unsuspected cases of child abuse/neglect also presented with lethal dehydration. Vitreous humor electrolyte levels and immunoassay for rotavirus were useful diagnostic adjuncts.
authors.affiliation: Department of Histopathology, Women's and Children's Hospital, Adelaide, Australia.
authors.forename: F J
authors.initials: FJ
authors.lastname: Whitehead
authors.forename: R T
authors.initials: RT
authors.lastname: Couper
authors.forename: L
authors.initials: L
authors.lastname: Moore
authors.forename: A J
authors.initials: AJ
authors.lastname: Bourne
authors.forename: R W
authors.initials: RW
authors.lastname: Byard
mesh_terms: D002648:Child; D002675:Child, Preschool; D003681:Dehydration / Q000209:etiology / Q000401:mortality* / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000150:complications / Q000821:virology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012401:Rotavirus / Q000302:isolation & purification