Intravital skin ulcer in a late 18th century Spanish child mummy: evidence for septicemic death?

During excavation campaigns carried out in north-eastern Spain (Aragonese), a well -preserved late 18th century infant mummy was exhumed from the topsoil of El Piquete church (Quinto, Zaragoza). At morphological macroscopical observation, a penetrating lesion lateral to the right knee was identified. The lesion was covered by linen bindings with a circumscribed brownish discoloration. Investigations were carried out with a special focus on the lower tight lesion in order to ascertain whether it had occurred intra-vitam, perimortem or post-mortem. A CT scan was performed to establish the age at death of the infant and to identify possible pathological disorders of the skeleton and internal organs. Histology was performed on the ovoid, deep penetrating lesion in order to determine whether it was vital or was due to taphonomic alterations. The body belonged to a male, 12-16 months old infant. It did not show any pathological disorder apart from the presence of an ovoid deep penetrating skin lesion lateral to the right knee. Histology showed that, apart from the typical postmortem alterations, several small haemosiderin deposits, such as in siderophages, were present, thus indicating, not only the vitality of the ulceration, but also its age of more than several days. We conclude that the infant survived the traumatic lesion for a few days and he most likely died of systemic infection related syndrome (SIRS). This rare case adds to the paleopathological literature on children's possible cause of death.