[Histologic and ultrastructural studies of the patient died of highly pathogenic H5N1 avian influenza virus infection in China].
OBJECTIVE
To explore histopathologic and ultrastructural characteristics of human avian influenza (AI) infection and related etiological pathogenesis.


METHODS
Postmortem lung and heart samples were collected from the patient who died of avian influenza virus infection on November 29, 2003 in China. Light and electron microscopy, immunohistochemistry and histochemistry were used to investigate the pathological changes.


RESULTS
The main pathological findings included extensive pulmonary consolidation, hemorrhage, pulmonary edema and local hemorrhagic infarct. The lamina of alveoli and bronchioles were abundantly filled with protein-rich fluid, erythrocytes, fibrin and cell debris admixed with many neutrophilis, macrophages, lymphocytes and a few of monokaryon and multinuclear giant cells. Hyaline membranes were formed. Local pulmonary tissues were heavily damaged by hemorrhage and necrosis. Alveolar septum was disintegrated. Mesenchymal edema with a few of macrophages infiltration of heart was found. Electron microscopy showed the avian influenza A virus-like particles (type C and type A) of 80 - 120 nm diameter and envelopes in the cytoplasm of pneumocytes and endothelial cells.


CONCLUSIONS
Fatal pneumonia associated with highly pathogenic avian influenza A virus (H5N1) infection leads to extensive pulmonary consolidation, edema and marked hemorrhagic necrosis and inflammation. Electron microscopy can identify avian influenza A virus-like particles. The findings may offer an important theoretical basis for clinical diagnosis and treatment.
Li
Ning
N
Department of Pathology, 309 Clinic Department of General Hospital of PLA, Beijing 100091, China. davidlee65@sina.com
Zhu
Qing-Yu
QY
Yu
Qi
Q
Wang
Wei
W
Wang
Yi-Ping
YP
D000818:Animals; D001344:Autopsy / Q000379:methods; D001717:Birds; D002681:China; D006801:Humans; D053124:Influenza A Virus, H5N1 Subtype / Q000472:pathogenicity* / Q000648:ultrastructure; D009980:Influenza A virus / Q000145:classification; D005585:Influenza in Birds / Q000473:pathology*; D007251:Influenza, Human / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery / Q000821:virology; D008854:Microscopy, Electron; D014463:Ultrasonography; D037521:Virulence Factors
D037521:Virulence Factors