Browsing by Author "Venter, Michaela Lucienne"

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    Profiling cardiovascular viral pathogens in cases of sudden and unexpected death in infants (SUDI) at the Tygerberg Medico-legal Mortuary and the role of myocarditis as a possible cause of death
    (Stellenbosch : Stellenbosch University., 2020-03) Venter, Michaela Lucienne; De Beer, Corena; Dempers, Johan; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Pathology. Medical Virology.
    ENGLISH ABSTRACT: Introduction: Sudden unexpected death in infancy (SUDI) is a heterogeneous group in which pathological changes, when observed, can either be an adequate or non-conclusive cause of death (COD). A non-conclusive COD is referred to as Sudden Infant Death Syndrome (SIDS), which is postulated to be the result of multiple risk factors including infection. Viral heart infections, resulting in myocarditis, reportedly contribute to SUDI cases. Numerous viruses have been associated with myocarditis, with few ever having been investigated in a South African context. Aim: The study aimed to investigate the presence of three specific viruses in the heart of SUDI cases admitted to the Tygerberg Medico-legal Mortuary over a one-year period. Methodology: Swab samples of the left ventricle of the heart were collected from SUDI cases admitted to the Tygerberg Medico-legal Mortuary over the period of one year. Concurrently, swabs and tissue were retrieved for microbiological and histological analysis, respectively. Conventional qualitative polymerase chain reaction assays were used to detect three deoxyribonucleic acid viruses, namely human adenovirus (HAdV), human bocavirus (HBoV) and parvovirus B19 (PVB19), possibly linked to myocarditis. Clinical history, sociodemographic information and the final COD were collected from case files. All viral results were compared to the histology of the tissue. Associations were investigated between sociodemographic information and viral presence through statistical analysis in order to identify significant risk factors. Results: Heart swabs were collected from 173 SUDI case, consisting of 93 males and 80 females and a mean age of 12.1 ± 9.8 weeks. Over half of the SUDI cases occurred in the cold seasons. The majority of the cases were assigned Infection as a COD, with just under half assigned as SIDS. Only one virus, HBoV, was detected in the heart tissue with implications of myocarditis histologically observed in one of the viral positive SUDI cases. Bacterial presence was also confirmed in only one case. All viral infections were observed in the cold seasons. Risk factors were highlighted between variable associations. Significant associations were observed between prematurity, room ventilation, birthweight and the COD. Significant associations were also observed between microbiology results, histology and the temperature on the day of death. Conclusion: The study expanded the knowledge regarding myocardial infections contributing to SUDI in the study population, as well as significant risk factors. Viral detection in the myocardium, supported by histological evidence, provided an improved way of classifying COD as infection.