Multiple Organ Invasion by Viruses: Pathological Characteristics in Three Fatal Cases of the 2009 Pandemic Influenza A/H1N1

To further understand the pathological characteristics of multiple organ involvement of the 2009 pandemic influenza A/H1N1 infection, tissues of bronchial mucosa, lung, myocardium, gastrocnemius, and liver from 3 patients with fatal A/H1N1 infections were investigated by light microscopy and transmi...

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Bibliographic Details
Published in:Ultrastructural pathology 2011-08, Vol.35 (4), p.155-161
Main Authors: Ru, Yong-xin, Li, Yue-chuan, Zhao, Yong, Zhao, Shi-xuan, Yang, Jing-Ping, Zhang, Hua-Mei, Pang, Tian-Xiang
Format: Article
Language:English
Subjects:
Adult
Aged
Bronchi - pathology
Bronchi - virology
Bronchiolitis - pathology
Bronchiolitis - virology
China - epidemiology
Fatty Liver - pathology
Fatty Liver - virology
Fibrosis - pathology
Fibrosis - virology
Heart - virology
Host-Pathogen Interactions
Humans
Influenza A Virus, H1N1 Subtype - genetics
Influenza A Virus, H1N1 Subtype - isolation & purification
Influenza A Virus, H1N1 Subtype - ultrastructure
influenza A/H1N1 virus
Influenza, Human - mortality
Influenza, Human - pathology
Influenza, Human - virology
Lung Diseases - pathology
Lung Diseases - virology
Male
Microscopy, Electron, Transmission
multiple organ
Multiple Organ Failure - mortality
Multiple Organ Failure - pathology
Multiple Organ Failure - virology
Muscle, Skeletal - pathology
Muscle, Skeletal - virology
muscular invasion
Myocardium - pathology
Necrosis - pathology
Necrosis - virology
Pandemics
Respiratory Mucosa - ultrastructure
Respiratory Mucosa - virology
Survival Rate
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Summary:To further understand the pathological characteristics of multiple organ involvement of the 2009 pandemic influenza A/H1N1 infection, tissues of bronchial mucosa, lung, myocardium, gastrocnemius, and liver from 3 patients with fatal A/H1N1 infections were investigated by light microscopy and transmission electron microscopy. In all 3 patients, bronchial mucosa showed necrotizing bronchiolitis, epithelial necrosis and desquamation, and squamous metaplasia, while lung consolidation or fibrosis was identified. Myocardium and gastrocnemius exhibited focal necrosis and fibrosis, surrounded by muscle cells showing features of cell damage. In liver, there was widespread fatty degeneration and necrosis, most often around the central lobular vein and portal area. Viral particles were found in all samples, frequently located in endothelium, epithelium, and muscle cells. The observations demonstrate that in fatal cases of A/H1N1 infection, viruses not only infect the respiratory system, but also engage in multiple organ invasions, causing pathologic changes.
ISSN:0191-3123
1521-0758
DOI:10.3109/01913123.2011.574249