Inflammatory responses in sudden infant death syndrome - past and present views

Sudden infant death syndrome (SIDS) is sudden unexpected death in infancy f or which there is no explanation based on commonly accepted diagnostic crit eria; however, half of the victims have had slight signs of infection prior to death. Such slight infection with fever is an important risk factor in combination with a prone sleeping position, especially in infants between 2 and 4 months of age. The purpose of this review is to summarise findings t hat support the theory that a significant part of cot deaths may be due to an overreaction to otherwise harmless infections. Such factors are mucosal immune stimulation, cytokines in the cerebrospinal fluid and hypoxanthine l evels in vitreous humour. The review aims at explaining why we believe that a slight infection combined with a prone position, a warm environment and a vulnerable age period may trigger a vicious circle leading to death. (C) 1999 Federation of European Microbiological Societies. Published by Elsevie r Science B.V. All rights reserved.