Immunohistochemical and molecular-pathological diagnosis of myocarditis in cases of suspected sudden infant death syndrome (SIDS) – A multicenter study

Virus-induced myocarditis is a common disease even in infants and children, but diagnosis can be difficult according to the Dallas-criteria, which have been criticised as being too unreliable. The diagnosis has been substantially improved due to immunohistochemical techniques for characterization and quantification of myocardial inflammatory reactions as well as molecular-pathological methods for viral genome detection. The published studies report on post-mortem samples from SIDS victims and controls which were prospectively investigated. Pediatric cases of unnatural deaths served as controls. The results demonstrate a clearly higher prevalence of viral myocardial infections in cases of suspected SIDS. Preliminary criteria for cellular immunohistochemical diagnosis of viral myocardial affections derived from these findings were suggested.