Related Experiment Video
Updated: Aug 19, 2026
Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest
Published on: May 26, 2023
Association of drowning and myocarditis in a pediatric population: an autopsy-based study
Gino R Somers1, Charles R Smith, Gregory J Wilson
1Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada. gino.somers@sickkids.ca <gino.somers@sickkids.ca>
Insights
Myocarditis, heart inflammation, was found in 23% of child drowning victims. This highlights the need for thorough autopsies in drowning cases to identify coexisting conditions like myocarditis.
Area of Science:
- Pediatric Pathology
- Forensic Medicine
- Cardiology
Background:
- Drowning is a leading cause of accidental death in children.
- The link between myocarditis (heart inflammation) and drowning is seldom reported.
- This study investigates the prevalence of myocarditis in pediatric drowning fatalities.
Purpose of the Study:
- To report five cases of childhood drowning with coexistent myocarditis.
- To emphasize the clinicopathologic significance of this association.
Main Methods:
- Retrospective review of autopsy records from 1998-2003.
- 1431 pediatric cases (0-18 years) were analyzed.
- Focus on identifying drowning victims with concurrent myocarditis.
Main Results:
- Twenty-two drowning cases were identified.
- Five (23%) of these drowning victims had coexistent myocarditis.
- Myocarditis was mild to moderate, focal, with lymphocyte and neutrophil infiltrates; Mycoplasma pneumoniae DNA detected in one case.
Conclusions:
- Myocarditis is present in a notable proportion of pediatric drowning fatalities.
- Thorough autopsy examination is crucial for seemingly simple drowning cases.
- This finding has significant clinicopathologic implications for understanding drowning deaths.
Context:
Drowning is a frequent cause of accidental death in childhood, but the association of myocarditis and drowning has only rarely been reported.
Objective:
To report 5 cases of drowning in children with coexistent myocarditis.
Design:
A retrospective review of autopsy records of patients 0 years to 18 years of age was performed during a 6-year period (1998-2003, total cases reviewed = 1431).
Results:
Twenty-two drownings were identified, in 14 male and 8 female children. Five patients (23%), 3 female and 2 male children, had coexistent myocarditis. The 5 patients ranged in age from 23 months to 13 years (mean, 7 years 2 months). None of the patients had antecedent symptomatology suggestive of myocarditis. In all patients, the myocarditis was focal mild or moderate, and the inflammatory infiltrate comprised lymphocytes with smaller numbers of neutrophils. All 5 patients had foci of myocyte necrosis. One patient had histologic evidence of myocardial hypertrophy but no evidence of a cardiomyopathy. Microbiologic studies, including culture, immunohistochemistry, polymerase chain reaction, and reverse transcriptase polymerase chain reaction, revealed Mycoplasma pneumoniae DNA in 1 case.
Conclusions:
The finding of myocarditis in a significant proportion of drowning victims in this series highlights the importance of a thorough autopsy examination in apparently straightforward cases and has clinicopathologic significance.
Related Concept Videos
01:21Myocarditis I: Introduction
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:30Cardiomyopathy II: Dilated Cardiomyopathy