Hydrocution in a case of Coxsackie virus infection

An apparently healthy 7-year-old boy attempted to demonstrate his ability t o dive into a whirlpool but was retrieved from the water in a state of unco nsciousness after several minutes. Resuscitation was unsuccessful. No chara cteristic signs of drowning were found at the autopsy but examination of th e lymph nodes and the cardiac muscle indicated a pre-existent infection. Th e histological examination revealed a slight degree of predominantly lympho cytic infiltration of the cardiac muscle. IgM antibodies against Coxsackie virus were: detected in the serum sample by means of ELISA. The reverse tra nscriptase polymerase chain reaction (RT-PCR) performed on an extract of fo rmalin-fixed, paraffin-embedded cardiac muscle tissue revealed a DNA sequen ce specific for Coxsackie B3 virus. Therefore, cardiac failure was due to a myocardial virus infection and the additional strain caused by diving. Thi s case report emphasizes the importance of modern molecular biological meth ods in cases of sudden death including death by hydrocution.