title: Novel Clinical and Pathologic Findings in a Heartland Virus-Associated Death.
abstract: We describe an investigation into a Heartland virus (HRTV)-associated death in Tennessee with novel clinical and pathologic findings. HRTV can cause rapidly fatal, widely disseminated infection with multisystem organ failure in patients without substantial comorbidities. We identified viral antigen in multiple organ tissues where it was not detected previously.
authors.affiliation: Centers for Disease Control and Prevention, Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Atlanta, Georgia, USA.|Tennessee Department of Health, Division of Communicable and Environmental Diseases and Emergency Preparedness, Nashville, Tennessee, USA.
authors.forename: Mary-Margaret A
authors.initials: MA
authors.lastname: Fill
authors.affiliation: Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, USA.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Compton
authors.affiliation: Vanderbilt University Medical Center, Department of Pathology, Microbiology, and Immunology, Nashville, Tennessee, USA.
authors.forename: Edward C
authors.initials: EC
authors.lastname: McDonald
authors.affiliation: Tennessee Department of Health, Division of Communicable and Environmental Diseases and Emergency Preparedness, Nashville, Tennessee, USA.
authors.forename: Abelardo C
authors.initials: AC
authors.lastname: Moncayo
authors.affiliation: Tennessee Department of Health, Division of Communicable and Environmental Diseases and Emergency Preparedness, Nashville, Tennessee, USA.
authors.forename: John R
authors.initials: JR
authors.lastname: Dunn
authors.affiliation: Vanderbilt University School of Medicine, Department of Health Policy, Nashville, Tennessee, USA.
authors.forename: William
authors.initials: W
authors.lastname: Schaffner
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Infectious Diseases Pathology Branch, Atlanta, Georgia, USA.
authors.forename: Julu
authors.initials: J
authors.lastname: Bhatnagar
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Infectious Diseases Pathology Branch, Atlanta, Georgia, USA.
authors.forename: Sherif R
authors.initials: SR
authors.lastname: Zaki
authors.affiliation: Tennessee Department of Health, Division of Communicable and Environmental Diseases and Emergency Preparedness, Nashville, Tennessee, USA.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
authors.affiliation: Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Infectious Diseases Pathology Branch, Atlanta, Georgia, USA.
authors.forename: Wun-Ju
authors.initials: WJ
authors.lastname: Shieh
mesh_terms: D000368:Aged; D000956:Antigens, Viral / Q000032:analysis; D001921:Brain / Q000473:pathology / Q000821:virology; D002044:Bunyaviridae Infections / Q000150:complications / Q000175:diagnosis* / Q000473:pathology* / Q000821:virology; D017809:Fatal Outcome; D006321:Heart / Q000821:virology; D006651:Histocytochemistry; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000473:pathology / Q000821:virology; D008297:Male; D008853:Microscopy; D009102:Multiple Organ Failure / Q000209:etiology* / Q000473:pathology*; D009206:Myocardium / Q000473:pathology; D016856:Phlebovirus / Q000145:classification / Q000302:isolation & purification*; D013714:Tennessee; D013737:Testis / Q000473:pathology / Q000821:virology
chemical_list: D000956:Antigens, Viral
keywords: emerging infections; heartland virus; tickborne disease; viral infections