Morrison C, Gilson T, Nuovo G J
Department of Pathology, Ohio State University Medical Center, Columbus, OH 43210-1228, USA.
Hum Pathol. 2001 Feb;32(2):216-21. doi: 10.1053/hupa.2001.21565.
Rotaviral infection is the most common cause of gastroenteritis in young children. Although rotavirus infection has a high morbidity and mortality rate in animals, in most cases in the United States the disease appears to be self-limited in humans. We report on 2 cases of fatal rotaviral infection in a 1 year old and a 4 year old. In each case, the illness showed a rapid systemic course dominated by cardiac and central nervous system involvement; in one case, rotaviral infection was documented by stool culture. Viral RNA was localized by reverse transcriptase in situ polymerase chain reaction to the mucosal cells of the small and large intestine and to many other tissues, including the heart and central nervous system, where it was noted in the endothelial cells of the microvasculature. Immunohistochemical analysis for the virus showed an identical histologic distribution in the intestinal epithelial cells and the systemic microvasculature. It is concluded that rotaviral infection can lead to a fatal disseminated infection in humans and the mechanism of this complication is based on a diffuse endothelialitis and concomitant tissue damage.
轮状病毒感染是幼儿肠胃炎最常见的病因。虽然轮状病毒感染在动物中具有高发病率和死亡率，但在美国的大多数情况下，该疾病在人类中似乎是自限性的。我们报告了1例1岁和1例4岁儿童的致命性轮状病毒感染病例。在每例病例中，疾病呈快速的全身病程，以心脏和中枢神经系统受累为主；其中1例通过粪便培养确诊为轮状病毒感染。通过逆转录原位聚合酶链反应，病毒RNA定位于小肠和大肠的黏膜细胞以及许多其他组织，包括心脏和中枢神经系统，在这些组织的微血管内皮细胞中也检测到病毒RNA。病毒的免疫组织化学分析显示，在肠道上皮细胞和全身微血管中具有相同的组织学分布。结论是，轮状病毒感染可导致人类致命的播散性感染，这种并发症的机制基于弥漫性内皮炎和伴随的组织损伤。
