Infant mortality, microglial nodules and parotid CMV-type inclusions

Nine hundred and fifty-one paediatric autopsies showed 24 cases in which the parotid contained cytomegalovirus-(CMV-) type inclusions. Parotid inclusions were found only during the first two years after birth. Of those with parotid inclusions, 15 showed microglial nodules in the brainstem and/or cerebellum. All the infants with microglial nodules were less than 6 months old. Only four infants without parotid inclusions showed microglial nodules. In just over half of the cases with parotid inclusions and microglial nodules death had been recorded as cases of sudden infant death syndrome. Whether there was any connection between the cause of death and microglial nodules remains uncertain as the microglial nodules were usually sparse and widely distributed. Some theories are proposed in this regard and in connection with those dying with parotid inclusions in the absence of microglial nodules. Until the question is finally resolved it may be prudent to view separately all cases of unexplained sudden death in infancy with evidence of CMV infection.