Sudden Infant Death Associated with Rhinovirus Infection

Abstract

A less than one-month-old infant with symptoms of rhinitis died unexpectedly in his sleep. He was not born prematurely and had no known underlying disease. Cerebrospinal fluid, nasopharyngeal and lung samples, and rectal swab were found to be positive for subgroup A rhinovirus, while the blood was negative. This case highlights the important finding that the rhinovirus, a common pathogen associated with upper respiratory tract infections, can sometimes, as the only pathogen, lead to complications such as a cerebrospinal infection and be involved in the sudden infant death syndrome (SIDS). Vigilance is necessary in case of viral infections in the infant's environment, and measures of hygiene and protection must be encouraged in order to reduce the risk of the SIDS.

Keywords: SIDS; central nervous system; cerebrospinal fluid; fatal; infant; infection; rhinovirus; sudden death; virus.

Figure 1

Histopathology of an autopsy lung sample of a 20-day-old boy in the context of sudden death linked to a rhinovirus infection. (A) HES, X150: histopathology showed pulmonary diffuse alveolar damage with a hyaline proteinaceous exudate in the alveoli and alveolar membranes, associated with luminal infiltration by numerous macrophages (arrows). (B) Anti-CD68, X1500: immunohistochemistry with anti-CD68: IgG1, clone KP1, and reference GA609 (DAKO) revealed numerous CD68+ macrophages inside alveoli (arrows). (C) Anti-rhinovirus antibody, X150: the rhinovirus was focally detected inside macrophages using anti-RV antibody: IgG1, clone 4966, and reference ABIN5688681 (Antibodies-online), targeting the VP3 viral protein (arrows). (D) Negative stain, X150: specific primary Ab was replaced by PBS and used as the negative control. The scale bar was 100 μm.