Routine microbiological testing in sudden and unexpected infant death.

OBJECTIVE: To evaluate the significance of microbiological test results in a series of infants who had died suddenly and unexpectedly. METHODOLOGY: Following a review of all cases of sudden natural death in infants presenting to the Adelaide Children's Hospital (ACH) division of the Women's and Children's Hospital (WCH) over the 10 year period between 1983 and 1992, specific evaluation of microbiological test results was undertaken. RESULTS: There were 329 cases of sudden infant death syndrome (SIDS) and 23 cases in which sudden infant death was either attributed to other conditions or was unclassifiable. Positive microbiological results were recorded in the majority of cases, most being considered to be due to postmortem overgrowth or to contamination at autopsy. Of the remaining cases, microbiological results were essential to the establishment of the diagnosis in three cases, and were a useful adjunct to the diagnosis in a further six cases. CONCLUSIONS: Routine microbiological testing in cases presenting as SIDS did not reveal occult sepsis in most instances. Such testing did, however, add support to the diagnosis of SIDS where no pathogens were isolated and, if not undertaken, would have resulted in a small percentage of cases of sudden infant death due to infections remaining undiagnosed.

Spinal mobility in young children. A normative study.

The purpose of this study was to collect values of back mobility on healthy children between the ages of 5 and 9 years. Normative values of back mobility have not been established for children under 10 years of age. Measurements of anterior and lateral spinal flexion were obtained from 282 children, using a standard flexion measurement procedure. Intraclass correlation estimates of reliability ranged from .77 to .89, indicating acceptable agreement and stability across and within raters. Girls demonstrated greater mobility than boys in all three measurements. Post hoc trend analyses revealed consistent increases in left and right lateral flexion with increasing age. No linear trend existed for anterior flexion. Using these data, we developed normative values of back mobility for each sex and age grouping. These measures of back mobility will provide the clinician with an empirically validated comparison to help identify early restrictions in back mobility in children with juvenile arthritis and other pediatric populations who are at risk for restrictions in back mobility. Early identification may lead to better prevention and more timely and effective treatment programs.

Toxic shock syndrome presenting to a paediatric service.

A case of toxic shock syndrome occurring in a 13-year-old and presenting to a paediatric service is described. Some implications are discussed including an approach to menstrual protection and the question of future contraceptive needs.