Diffuse bilateral retinal hemorrhages in an infant with a coagulopathy and prolonged cardiopulmonary resuscitation

• Authors: Joshua D. Levinson, Emory University; Melissa A. Pasquale, Fulton County Medical Examiner Center; Scott Lambert, Emory University
• Journal Title: Journal of AAPOS
• Volume: Volume 20, Number 2
• Publisher: Elsevier | 2016-04-01, Pages 166-168
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.jaapos.2015.11.003
• Subjects: Health Sciences, Opthamology; Health Sciences, Medicine and Surgery
• Keywords: Cardiopulmonary Resuscitation; Cause of Death; Disseminated Intravascular Coagulation; Fatal Outcome; Heart Arrest; Humans; Infant; Male; Myocardial Infarction; Retinal Hemorrhage; Tomography, X-Ray Computed

Abstract

We report a case of diffuse bilateral retinal and optic nerve sheath hemorrhages in an 8-week-old boy who was found unresponsive. The child underwent prolonged cardiopulmonary resuscitation and was noted on admission to have a coagulopathy. An autopsy determined the cause of death to be a myocardial infarct in the distribution of an anomalous coronary artery. This case demonstrates the difficulty that may occur in establishing whether child abuse caused death in the setting of another potential cause of mortality.