The pathology of cot deaths

Abstract

An examination of the pathological features of 12 consecutive cases of sudden death in infancy was undertaken with particular reference to the lung changes. A combined radiological and pathological study of formalin vapor-inflated lungs was carried out. Certain common features in the cases in which there are no post mortem changes to explain death (typical cot deaths) are described and compared with cases with an acceptable cause of death and with control cases. Severe dehydration is a potentially avoidable factor underlying cot deaths and many other sudden infant deaths with no explainable causes. Petechial hemorrhages are a constant feature of cot deaths and indicate a respiratory/hypoxic mode of death. Absence of petechiae indicates some other explanation for death. The minor respiratory or other infections usually present at autopsy in cot deaths may sometimes exaggerate a preexisting state of dehydration. The dehydration may contribute more directly to death than the infection.