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Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death.

Abstract

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.

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  • Authors+Show Affiliations

    ,

    Children's Hospital-San Diego, CA 92123, USA. hkrous@chsd.org

    , , ,

    Source

    MeSH

    Accidents
    Automobiles
    Beds
    Child
    Child, Preschool
    Dehydration
    Fatal Outcome
    Female
    Fever
    Heat Stress Disorders
    Homicide
    Humans
    Infant
    Male
    Postmortem Changes
    Purpura

    Pub Type(s)

    Case Reports
    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    11764905

    Citation

    Krous, H F., et al. "Environmental Hyperthermic Infant and Early Childhood Death: Circumstances, Pathologic Changes, and Manner of Death." The American Journal of Forensic Medicine and Pathology, vol. 22, no. 4, 2001, pp. 374-82.
    Krous HF, Nadeau JM, Fukumoto RI, et al. Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death. Am J Forensic Med Pathol. 2001;22(4):374-82.
    Krous, H. F., Nadeau, J. M., Fukumoto, R. I., Blackbourne, B. D., & Byard, R. W. (2001). Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death. The American Journal of Forensic Medicine and Pathology, 22(4), pp. 374-82.
    Krous HF, et al. Environmental Hyperthermic Infant and Early Childhood Death: Circumstances, Pathologic Changes, and Manner of Death. Am J Forensic Med Pathol. 2001;22(4):374-82. PubMed PMID: 11764905.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Environmental hyperthermic infant and early childhood death: circumstances, pathologic changes, and manner of death. AU - Krous,H F, AU - Nadeau,J M, AU - Fukumoto,R I, AU - Blackbourne,B D, AU - Byard,R W, PY - 2002/1/5/pubmed PY - 2002/5/29/medline PY - 2002/1/5/entrez SP - 374 EP - 82 JF - The American journal of forensic medicine and pathology JO - Am J Forensic Med Pathol VL - 22 IS - 4 N2 - 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. SN - 0195-7910 UR - https://www.unboundmedicine.com/medline/citation/11764905/full_citation L2 - http://Insights.ovid.com/pubmed?pmid=11764905 DB - PRIME DP - Unbound Medicine ER -