Dept. of Pathology, State University of New York Upstate Medical University, 750 E. Adams Street, Syracuse, NY 13210, USA.
Am J Clin Pathol. 2010 Mar;133(3):380-7. doi: 10.1309/AJCPXY17SULQKSWK.
Although novel influenza A (H1N1) virus infection has assumed pandemic proportions, there are few reports of the pathologic findings. Herein we describe the pathologic findings of novel influenza A (H1N1) infection based on findings in 2 autopsy cases. The first patient, a 36-year-old man, had flu-like symptoms; oseltamivir (Tamiflu) therapy was started 8 days after onset of symptoms, and he died on day 15 of his illness. At autopsy, the main finding was diffuse alveolar damage with extensive fresh intra-alveolar hemorrhage. The second patient, a 46-year-old woman with alcoholism, was found unresponsive in a basement and brought to the hospital intoxicated and confused. Her condition deteriorated rapidly, and she died 4 days after admission. The main autopsy finding was acute bronchopneumonia with gram-positive cocci, intermixed with diffuse alveolar damage. The pathologic findings in these contrasting cases of novel influenza A (H1N1) infection are similar to those previously described for seasonal influenza. The main pathologic abnormality in fatal cases is diffuse alveolar damage, but it may be overshadowed by an acute bacterial bronchopneumonia.
虽然新型甲型 H1N1 流感病毒感染已呈现大流行态势，但有关其病理发现的报道甚少。在此，我们根据 2 例尸检病例描述新型甲型 H1N1 流感感染的病理发现。第一例患者为 36 岁男性，出现流感样症状；起病 8 天后开始给予奥司他韦（达菲）治疗，于发病第 15 天死亡。尸检主要发现为弥漫性肺泡损伤，伴有广泛的新鲜肺泡内出血。第二例患者为 46 岁女性，有酗酒史，在地下室被发现失去知觉，送至医院时处于醉酒和昏迷状态。病情迅速恶化，入院后 4 天死亡。尸检主要发现为急性支气管肺炎，伴有革兰阳性球菌，混合弥漫性肺泡损伤。这两例新型甲型 H1N1 流感感染的对比病例的病理发现与季节性流感先前描述的相似。弥漫性肺泡损伤是致命病例的主要病理异常，但可能被急性细菌性支气管肺炎所掩盖。
