Can a cat smother and kill a baby?

Abstract

A 5-week-old previously healthy baby girl was found in her pram with a cat lying over her face. She was deeply cyanosed and gasping. Her father, a doctor, gave mouth-to-mouth resuscitation, and her colour and breathing became normal after about 30 seconds. A few hours later she had severe diarrhoea, fever, and poor peripheral circulation and was admitted to hospital. Examination showed no abnormalities apart from her blue-grey colour and tachypnoea. There was biochemical evidence of slight dehydration with severe metabolic acidosis (pH 7.18), which was corrected. Lumbar puncture showed no abnormality, urine and cerebrospinal fluid were sterile, and no pathogenic bacteria were found in the stools. The diarrhoea stopped after two days. An electroencephalogram taken a few days later was abnormal, with spikes and waves over the frontal and temporal regions. During the next few days she had several convulsions, which responded to phenobarbitone. Over the subsequent months her psychomotor development was clearly retarded and she again had convulsions consistent with infantile spasms. Electroencephalography showed hypsarrhythmia. She was treated with adrenocorticotrophic hormone but died at the age of 8 months from bronchopneumonia. Postmortem examination showed bronchopneumonia as the immediate cause of death. The brain was severely shrunken and showed massive bilateral symmetrical dissolution of the white matter of the cerebral hemispheres and multiple cystic trabeculated cavities of varying size. There was severe focal atrophy of the cerebral cortex. Histologically there was massive loss of brain substance with widespread gliosis. There was loss of Purkinje cells, and some of the surviving ones had poorly demarcated fluffy borders.