Pandemic influenza A/H1N1: comparative analysis of microscopic lung histopathological findings

To analyze the histopathological lung findings of four fatal cases of the 2009 H1N1 influenza pandemic and their correlation with clinical and epidemiological characteristics. Descriptive data from medical records of four patients who died in the Intensive Care Unit of a university hospital in 2009....

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Bibliographic Details
Published in:Einstein (São Paulo, Brazil) Brazil), 2012-07, Vol.10 (3), p.306-311
Main Authors: Marchiori, Roberta, Bredt, Carla Sakuma de Oliveira, Campos, Marcos Menezes Freitas de, Negretti, Fábio, Duarte, Péricles Almeida Delfino
Format: Article
Language:English
Subjects:
Adult
Aged
Brazil - epidemiology
Fatal Outcome
Female
H1N1 subtype
Humans
Influenza A virus
Influenza A Virus, H1N1 Subtype
Influenza, Human - epidemiology
Influenza, Human - pathology
Influenza, Human - virology
Intensive care units
Lung - pathology
Lung - virology
Middle Aged
Pandemics
Pregnancy
Retrospective Studies
Young Adult
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Summary:To analyze the histopathological lung findings of four fatal cases of the 2009 H1N1 influenza pandemic and their correlation with clinical and epidemiological characteristics. Descriptive data from medical records of four patients who died in the Intensive Care Unit of a university hospital in 2009. Nasopharyngeal aspirate specimens were collected from the patients and were analyzed by real-time polymerase chain reaction. Lung biopsy was performed post mortem; a score of intensity for pathological changes was applied. Three patients had positive real-time polymerase chain reaction (although all of them had a clinical diagnose of influenza H1N1). The main histopathological changes were: exudative diffuse alveolar damage with atelectasis; varying degrees of alveolar hemorrhage and edema, necrosis and sloughing of the respiratory epithelium in several bronchioli; and thrombus formation. One of the patients (the pregnant one) presented histopathological findings of cytomegalic inclusion. The pulmonary histopathological findings in patients with fatal 2009 H1N1 influenza pandemic disclosed intense alveolar damage and hemorrhage and severe bronchiolitis. A co-infection with cytomegalovirus was described in the pregnant patient.
ISSN:1679-4508
2317-6385
DOI:10.1590/S1679-45082012000300009