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Case Reports
. 2009 May;40(5):735-9.
doi: 10.1016/j.humpath.2008.08.015. Epub 2009 Jan 3.

Systemic infection of avian influenza A virus H5N1 subtype in humans

Zengfeng Zhang  1 , Jinxia Zhang, Kai Huang, Kang-Sheng Li, Kwok-Yung Yuen, Yi Guan, Honglin Chen, Wai Fu Ng
Affiliations
Case Reports

Systemic infection of avian influenza A virus H5N1 subtype in humans

Zengfeng Zhang et al. Hum Pathol. 2009 May.

Abstract

The viral dissemination in a patient with avian influenza A subtype H5N1 infection was retrospectively studied by the immunohistochemical localization of viral nucleoprotein antigen. The pathology was marked by diffuse alveolar damage, lymphoid depletion, and reactive hemophagocytic syndrome. Besides the lung and the upper respiratory tract, viral antigen was detected in the small and large intestinal epithelial cells, hematopoietic cells in the bone marrow, glial cells and neurons of the brain, and lymphocytes. The results confirmed that H5N1 virus disseminated to multiple organs beyond the respiratory system. However, specific pathological changes were noted in the respiratory system only, and productive viral replication confirmed by culture was noted only in the lung. More postmortem studies are needed to elucidate the pathogenesis of this highly fatal zoonotic disease.

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Figures

Fig. 1
Fig. 1
Characterization of the monoclonal anti-NP antibody. A, Western blot with anti-NP in lysates of (1) cultured 293 cells and (2) cultured 293 cells transfected with NP plasmid. The band showed localization of NP at about 50 kd. B-C, Immunohistochemistry of lung sections of mouse infected with H5N1 virus. Positive reaction was demonstrated by brown reaction of the nuclei. B, Positive epithelial cells in bronchiolar epithelium. C, Negative control with anti-HPV. Upper part bronchiolar epithelium and lower part alveolar septum (original magnifications: B ×1000, C ×630).
Fig. 2
Fig. 2
Pathological changes. A, Tracheal epithelium with regenerative hyperplasia. B, Lung with diffuse alveolar damage and bronchiolar epithelial hyperplasia in left lower corner. C, High-power view of alveoli with fibrin, red cell and inflammatory cells in alveolar lumen, and plump pneumocytes in the septa. D, Bone marrow with hemophagocytosis of red cells and an erythroblast (>) (hematoxylin and eosin stain, original magnifications: A and C ×630, B ×100, D ×1000).
Fig. 3
Fig. 3
Immunohistochemical demonstration of viral NP. Positive reaction was demonstrated by brown reaction of the nuclei. A, Reactive tracheal epithelium with high-power view in inset 2. Inset 1 showed control section with anti-HPV. B, Lung alveolus with positive pneumocytes (<) along the septum and 1 positive lymphocyte in the lumen (<). Inset 1 showed high-power view of the reactive pneumocytes, and inset 2 showed control alveolus of a patient with SARS. C, Small intestine with positive epithelial cells and high-power view in inset 1. Inset 2 showed small intestine of a patient with SARS. D, Large intestine with positive epithelial cells and high-power view in inset. E, Bone marrow with reactive myelocytes (<) and erythroblasts (<<) and high-power view in inset 1 showed 2 reactive megakaryocytes. Inset 2 showed control section with anti-HPV. Inset 3 showed bone marrow of a patient with SARS. F, Midbrain with a reactive neuron. Inset 1 showed a high-power view of the reactive neuron with an adjacent nonreactive astrocyte and another pair of negative neurons and astrocytes above. Inset 2 showed the cerebral cortex with an elongated reactive astrocyte, 3 negative small neurons with round nuclei, and another negative astrocyte with slightly elongated nuclei (original magnifications ×400, except B1, E1, F1 ×1000; C1, D inset, E, F2 ×800).
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References

    1. Chen H., Smith G.J., Li K.S. Establishment of multiple sublineages of H5N1 influenza virus in Asia: implications for pandemic control. Proc Natl Acad Sci U S A. 2006;103:2845–2850. - PMC - PubMed
    1. Cumulative number of confirmed human cases of avian influenza A/(H5N1) reported to WHO. May 28, 2008. http://www.who.int/csr/disease/avian_influenza/country/cases_table_2008_... [accessed June 19, 2008].
    1. Ng W.F., To K.F., Lam W.W., Ng T.K., Lee K.C. The comparative pathology of severe acute respiratory syndrome and avian influenza A subtype H5N1—a review. Hum Pathol. 2006;37:381–390. - PMC - PubMed
    1. Ng W.F., To K.F. Pathology of human H5N1 infection: new findings [comment] Lancet. 2007;370:1106–1108. - PubMed
    1. Gu J., Xie Z., Gao Z. H5N1 infection of the respiratory tract and beyond: a molecular pathology study. Lancet. 2007;370:1137–1145. - PMC - PubMed

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