Case ReportsDeath of a Neonate With a Negative Autopsy and Ketoacidosis A Case Report of Propionic AcidemiaKrizova, Adriana MD, MSc, FRCPC; Herath, Jayantha C. MD, MSc, DLM, MD (Forensic), FRCPC(AP & FP)Author Information From the Provincial Forensic Pathology Unit, Toronto, Ontario, Canada. Manuscript received May 30, 2014; accepted January 3, 2015. The authors report no conflict of interest. Reprints: Jayantha C Herath MD, MSc, DLM, MD (Forensic), FRCPC(AP & FP) Provincial Forensic Pathology Unit, 25 Morton Shulman Ave, Toronto, Ontario, Canada M3M 0B1. E-mail: [email protected]. The American Journal of Forensic Medicine and Pathology: September 2015 - Volume 36 - Issue 3 - p 193-195 doi: 10.1097/PAF.0000000000000156 Buy Metrics Abstract Facing a sudden neonatal death in the forensic setting brings to mind enormous differential diagnostic possibilities. This case report demonstrates that at times, when no anatomical cause of death is apparent after a postmortem examination, ancillary testing can lead to diagnosis. In this case, ancillary testing showed ketosis and further workup showed presence of propionic acidemia in a 3-day-old neonate. © 2015 by Lippincott Williams & Wilkins.