Histopathological findings in a critically ill patient with avian influenza A (H7N9)

被引:10
作者
Huang, Jin-Bao [1 ]
Li, Hong-Yan [1 ]
Liu, Jia-Fu [2 ]
Lan, Chang-Qing [3 ]
Lin, Qing-Hua [2 ]
Chen, Shu-Xing [4 ]
Zhang, Hong-Ying [1 ]
Wang, Xin-Hang [1 ]
Lin, Xu [1 ]
Pan, Jian-Guang [1 ]
Weng, Heng [1 ]
机构
[1] Fujian Med Univ, Educ Hosp, Fuzhou Pulm Hosp Fu Jian, Dept Resp Med, 2 Hubian, Fuzhou 350008, Peoples R China
[2] Fujian Med Univ, Educ Hosp, Fuzhou Pulm Hosp Fu Jian, Dept Pathol, Fuzhou 350008, Peoples R China
[3] Fujian Med Univ, Educ Hosp, Fuzhou Pulm Hosp Fu Jian, Dept Radiol, Fuzhou 350008, Peoples R China
[4] Fujian Med Univ, Educ Hosp, Fuzhou Pulm Hosp Fu Jian, Dept Thorac Surg, Fuzhou 350008, Peoples R China
关键词
Influenza virus; avian; H7N9; histopathology; oseltamivir; pneumonia; FATAL HUMAN INFECTIONS; A(H7N9) VIRUS;
D O I
10.3978/j.issn.2072-1439.2015.11.59
中图分类号
R56 [呼吸系及胸部疾病];
学科分类号
摘要
To date, data regarding the pulmonary histopathology of human H7N9 disease are scarce. We herein describe a patient with a severe case of avian influenza A (H7N9). A chest computerized tomography (CT) scan showed diffuse ground-glass opacities and consolidation throughout the lungs. A resection of pulmonary bullae in the right middle lobe was performed by video-assisted thoracic surgery (VATS) based on the extracorporeal membrane oxygenation (ECMO) supportive technique on the 23rd day after the onset of symptoms because of a right pneumothorax persistent air leak. The histopathological findings of the resected lung tissue revealed pneumocyte hyperplasia and fibroproliferative changes along with diffuse alveolar damage. Bronchoalveolar lavage fluid (BALF) specimens for influenza A (H7N9) virus were continuously positive for more than three weeks, despite oseltamivir treatment, and continuous viral replication significantly prolonged the course of the disease. The patient's clinical status continuously deteriorated, with the development of refractory hypoxemia due to progressive and rapid lung fibrosis, which was confirmed by the final histological changes observed from a limited post-mortem biopsy of lung tissue. Pre-terminally, he developed multi-organ failure and died on the 39th day after symptom onset, despite corticosteroid treatment.
引用
收藏
页码:E672 / E677
页数:6
相关论文
共 8 条
  • [1] Bai Yan-qiong, 2006, Zhonghua Bing Li Xue Za Zhi, V35, P545
  • [2] Human infections with the emerging avian influenza A H7N9 virus from wet market poultry: clinical analysis and characterisation of viral genome
    Chen, Yu
    Liang, Weifeng
    Yang, Shigui
    Wu, Nanping
    Gao, Hainv
    Sheng, Jifang
    Yao, Hangping
    Wo, Jianer
    Fang, Qiang
    Cui, Dawei
    Li, Yongcheng
    Yao, Xing
    Zhang, Yuntao
    Wu, Haibo
    Zheng, Shufa
    Diao, Hongyan
    Xia, Shichang
    Zhang, Yanjun
    Chan, Kwok-Hung
    Tsoi, Hoi-Wah
    Teng, Jade Lee-Lee
    Song, Wenjun
    Wang, Pui
    Lau, Siu-Ying
    Zheng, Min
    Chan, Jasper Fuk-Woo
    To, Kelvin Kai-Wang
    Chen, Honglin
    Li, Lanjuan
    Yuen, Kwok-Yung
    [J]. LANCET, 2013, 381 (9881) : 1916 - 1925
  • [3] Molecular pathology analyses of two fatal human infections of avian influenza A(H7N9) virus
    Feng, Yanling
    Hu, Lvyin
    Lu, Shuihua
    Chen, Qingguo
    Zheng, Ye
    Zeng, Dong
    Zhang, Jun
    Zhang, Anli
    Chen, Liang
    Hu, Yunwen
    Zhang, Zhiyong
    [J]. JOURNAL OF CLINICAL PATHOLOGY, 2015, 68 (01) : 57 - 63
  • [4] Pathological changes in a patient with acute respiratory distress syndrome and H7N9 influenza virus infection
    Guo, Qiang
    Huang, Jian-an
    Zhao, Daguo
    Jin, Jun
    Liu, Shenlang
    Fraidenburg, Dustin R.
    [J]. CRITICAL CARE, 2014, 18 (06):
  • [5] He Yao-xin, 2010, Beijing Da Xue Xue Bao Yi Xue Ban, V42, P137
  • [6] Lu Min, 2008, Chinese Journal of Pathology, V37, P145
  • [7] Fatal H7N9 pneumonia complicated by viral infection of a prosthetic cardiac valve - An autopsy study
    Nicholls, John M.
    Tsai, Polly N. W.
    Chan, Renee W. Y.
    Hui, Kenrie P. Y.
    Chan, Michael C. W.
    Peiris, J. S. Malik
    Chan, K. H.
    Yuen, K. Y.
    To, Kelvin K. W.
    [J]. JOURNAL OF CLINICAL VIROLOGY, 2014, 61 (03) : 466 - 469
  • [8] Clinical, Virological, and Histopathological Manifestations of Fatal Human Infections by Avian Influenza A(H7N9) Virus
    Yu, Liang
    Wang, Zhaoming
    Chen, Yu
    Ding, Wei
    Jia, Hongyu
    Chan, Jasper Fuk-Woo
    To, Kelvin Kai-Wang
    Chen, Honglin
    Yang, Yida
    Liang, Weifeng
    Zheng, Shufa
    Yao, Hangping
    Yang, Shigui
    Cao, Hongcui
    Dai, Xiahong
    Zhao, Hong
    Li, Ju
    Bao, Qiongling
    Chen, Ping
    Hou, Xiaoli
    Li, Lanjuan
    Yuen, Kwok-Yung
    [J]. CLINICAL INFECTIOUS DISEASES, 2013, 57 (10) : 1449 - 1457