Acute fulminant, fatal coxsackie B virus infection: a report of two cases.

Within a space of four months, between March to June 1993, medico-legal autopsies on 9 sudden infant deaths from natural causes were conducted at the Department of Forensic Medicine. Of these, 6 were due to unspecified interstitial pneumonitis or myocarditis (consistent with viral aetiologies), while 1 was attributed to adenovirus infection. The remaining 2 were due to fulminant Coxsackie virus (type B1) infection, where the post-mortem findings included leptomeningitis, myocarditis, florid interstitial pneumonitis, pancreatitis and focal hepatic necrosis. Coxsackie B viruses are often implicated in perinatal disease and, together with other viral infections, should be considered in the investigation of all sudden infant deaths.