H5N1-infected cells in lung with diffuse alveolar damage in exudative phase from a fatal case in Vietnam.
Necropsied lung tissues of three fatal cases with avian influenza A virus (H5N1) infection in Vietnam were analyzed to detect H5N1 virus-infected cells. Formalin-fixed and paraffin-embedded lung tissue sections showed typical histological features of diffuse alveolar damage (DAD) in all cases. Immunohistochemistry for the influenza A virus nucleoprotein antigen revealed positive signals of bronchiolar and alveolar epithelial cells in only one patient, who exhibited DAD with an exudative phase and died on the 6th day after onset. However, no signal was detected in the other two cases of DAD with a proliferative phase. These patients died on day 16 and day 17 after onset, respectively. H5N1 virus antigens were detected predominantly in epithelial cells in terminal bronchioles and in alveoli, i.e., type I and type II alveolar pneumocytes, and in alveolar macrophages. The pathogenesis of exudative DAD caused by H5N1 infection is discussed.
Liem
Nguyen Thanh
NT
The National Hospital of Pediatrics, Hanoi, Vietnam.
Nakajima
Noriko
N
Phat
Le Phuc
le P
Sato
Yuko
Y
Thach
Hoang Ngoc
HN
Hung
Pham Viet
PV
San
Luong Thi
LT
Katano
Harutaka
H
Kumasaka
Toshio
T
Oka
Teruaki
T
Kawachi
Shoji
S
Matsushita
Takeji
T
Sata
Tetsutaro
T
Kudo
Koichiro
K
Suzuki
Kazuo
K
D000956:Antigens, Viral; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000276:immunology* / Q000302:isolation & purification; D007251:Influenza, Human / Q000473:pathology* / Q000821:virology; D008168:Lung / Q000473:pathology / Q000821:virology; D008297:Male; D011650:Pulmonary Alveoli / Q000473:pathology* / Q000821:virology; D014744:Vietnam
D000956:Antigens, Viral