title: The role of Coxsackievirus A16 in a case of sudden unexplained death in an infant - A SUDI case.
abstract: The Coxsackievirus A16 (CV-A16) is one of the main pathogens causing hand-foot-and-mouth disease in young children. It is a low-virulence virus rarely involved in serious illness. It is seen sporadically or in outbreaks all over the world. We report a case of sudden unexplained death in infancy, SUDI, in a 3 and 1/2 months old infant, in which a thorough post mortem investigation pointed at a fatal infection with CV-A16 as the most likely cause of death. Only five cases of fatal CV-A16 infection have been published and none of these presented as sudden death. The fatal cases involved two infants, two young children and an elderly man. Post mortem, pre-autopsy CT-scan and C-reactive protein analysis allowed for an autopsy procedure targeted at a microbiological cause of death. The case illustrates the usefulness of supplementary testing during autopsy.
authors.affiliation: Institute of Forensic Medicine, University of Southern Denmark, J.B. Winsløwsvej 17, 5000 Odense C, Denmark. Electronic address: bastrup@health.sdu.dk.
authors.forename: B S
authors.initials: BS
authors.lastname: Astrup
authors.affiliation: Department of Pathology, Odense University Hospital, J.B. Winlsøwsvej 15, 5000 Odense C, Denmark.
authors.forename: I B G
authors.initials: IB
authors.lastname: Johnsen
authors.affiliation: Microbiological Diagnostics and Virology, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark.
authors.forename: A L
authors.initials: AL
authors.lastname: Engsbro
mesh_terms: D003384:Coxsackievirus Infections / Q000175:diagnosis*; D004770:Enterovirus / Q000302:isolation & purification*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D008171:Lung Diseases / Q000175:diagnosis / Q000382:microbiology*; D013398:Sudden Infant Death / Q000209:etiology*
keywords: C-reactive protein; CRP; Coxsackievirus; Post-mortem radiology; Sudden infant death