Intestinal epithelial damage in sids babies and its similarity to that caused by bacterial toxins in the rabbit.

Sections of the duodenum, jejunum, ileum, caecum and large intestine from 14 sudden infant death syndrome (SIDS) babies were examined by scanning (SEM) and transmission electron microscopy (TEM). The type and amount of damage was characterised and quantitated and compared with the presence of Clostridium perfringens, Clostridium difficile, Escherichia coli and Staphylococcus aureus in faecal samples from the babies and toxins from the bacteria in faecal samples and serum from the babies. The data were compared with the damage that these toxins cause to the rabbit intestinal epithelium (see the previous paper in this issue). Damage was present in most of the SIDS samples, varying from 0 to 96%, and most damage occurred when the faecal samples contained the above bacteria and their toxins. Damage varied from removal of microvilli, damage to villus tips, separation of and removal of epithelial cells from the lamina propria, and removal of enterocytes leaving goblet and tuft cells, to damage and breakdown of the lamina propria. The results support the hypothesis that the cause of death in a significant proportion of SIDS babies may result from the absorption of toxins from the intestinal tract initiating a toxic shock reaction.