Suppurative tonsillitis and sudden cardiac death due to physical training in a young soccer player

A teenager aged 17 was a professional soccer player, and was without symptoms. He died suddenly during physical exercise at the field. All reanimation efforts were unsuccessfull. At the forensic autopsy he had suppurative bacterial tonsillitis, subacute diffuse myopericarditis and narrowing of the ascending aorta of 10 mm. In Croatia the death rate among athletes reached 0.15/100,000, in athletes suffered of acute respiratory tract infections 0.34/100,000, in males who practice exercise recreatively 0.75/100,000 (p = 0.0014), in school children 1.0/100,000 (p = 0.0010). Physical exercise is contraindicated in acute respiratory tract infections. Every such case has to be treated by physician. When to start with physical training after suppurative-bacterial tonsillitis depends on disappearing of clinical signs, normalization of erythrocite sedimentation rate; of white cell count and serum level of C-reactive protein. Physical exercise is contraindicated in patients suffering of myopericarditis for at least 6 months. When to start exercise depends on disappearing of subjective symptoms and normalization of clinical and laboratory findings.