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[汉坦病毒心肺综合征致死病例的形态学发现。7例尸检报告]

[Morphological findings in fatal cases of hantavirus cardiopulmonary syndrome. Report of 7 autopsies].

作者信息

Guzmán G Pablo, Tapia E Oscar, Villaseca H Miguel, Araya O Juan, Antonio P Lilia, Lee O Bolívar, Roa S Juan

机构信息

Universidad de La Frontera, Temuco, Chile. Departamento de Anatomia Patológica, Facultad de Medicina.

出版信息

Rev Chilena Infectol. 2010 Oct;27(5):398-405. doi: 10.4067/s0716-10182010000600003.

Abstract

INTRODUCTION

Hantavirus cardiopulmonary syndrome (HCPS) is an acute infectious disease characterized by sudden cardiorespiratory failure and high mortality, caused by a RNA virus of the genus Hantavirus, family Bunyaviridae, 15% of Chilean cases have been detected in the Araucania Region.

OBJECTIVE

To determine in fatal cases of HCPS, clinical and morphological characteristics.

MATERIALS AND METHODS

Descriptive-retrospective analysis of seven fatal cases with postmortem study of HCPS, attended between 1997 and 2009 at the Hospital of Temuco, Chile.

RESULTS

Cases were young patients from rural areas, and presented as an illness of progressive respiratory failure, with leukocytosis, thrombocytopenia and bilateral interstitial pulmonary infiltrates. Main morphological findings were marked intersticial and intraalveolar pulmonary edema, with minimal epithelial injury and mononuclear cell intersticial infiltrate and mild edematous intersticial inflamatory process.

CONCLUSIONS

Epidemiological, clinical and laboratory background allow to suspect HCPS. In fatal cases, the autopsy makes possible to discard other similar pathologies and provide tissue for confirmation of the disease.

摘要

引言

汉坦病毒心肺综合征(HCPS)是一种急性传染病,其特征为突发心肺功能衰竭且死亡率高,由布尼亚病毒科汉坦病毒属的一种RNA病毒引起。智利15%的病例在阿劳卡尼亚地区被检测到。

目的

确定HCPS死亡病例的临床和形态学特征。

材料与方法

对1997年至2009年期间在智利特木科医院就诊的7例HCPS死亡病例进行描述性回顾分析,并进行尸检研究。

结果

病例均为来自农村地区的年轻患者,表现为进行性呼吸衰竭疾病,伴有白细胞增多、血小板减少和双侧间质性肺浸润。主要形态学发现为明显的间质和肺泡内肺水肿,上皮损伤轻微,单核细胞间质浸润,间质有轻度水肿性炎症过程。

结论

流行病学、临床和实验室背景有助于怀疑HCPS。在死亡病例中,尸检可以排除其他类似病症,并为疾病确诊提供组织样本。

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