Mozart's Death: A Rebuttal of Karhausen. Further evidence for Schönlein-Henoch Syndrome

Infective Endocarditis and Phlebotomies May Have Killed Mozart

Thirty-five year-old Amadeus Mozart died in Vienna after an acute illness that lasted only 15 days but no consensus has been reached on the cause of his death. From many letters written by his farther it is almost certain that he experienced at least three episodes of acute rheumatic fever attack in his childhood, and a relapse of rheumatic fever was suggested to have killed Mozart, although death from acute rheumatic fever is very rare in adults. His last illness was characterized by high fever, massive edema, vomiting and skin rash. His last illness can be explained by infectious endocarditis and heart failure. During his last hours, he was given phlebotomy, possibly for the third time in two weeks, and soon after he became unconscious and died. As such, phlebotomy performed on a man dehydrated by high fever and vomiting may have caused systemic shock. In summary, Mozart probably died from chronic rheumatic heart disease complicated by infective endocarditis and heart failure, and repeated phlebotomy-induced hypovolemic shock.

Henoch-Schönlein purpura: a review article

Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. Although HSP is typically a disease of children, adult cases have been described. HSP can affect multiple organs with a characteristic rash present in all patients. Most cases resolve with symptomatic treatment, but serious complications can occur such as renal failure. Primary care physicians should be well aware of the disease because the true incidence is probably underestimated.

Mozart's last months and controversial death

The controversies about the cause of Mozart's death are related to the unusual nature of his symptoms as recounted by lay people, the absence of a medical record, the inordinate amount of publicity given over to the sensational poisoning allegations, and the substantial difficulty in the evaluation of the diverse original sources1–20. The controversies are especially concerned with the question of preexisting chronic illness and the interpretation of the swellings. A chronology of major events in the last few months of Mozart's life is given in Table 1.