Infectious Diseases Pathology Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Am J Trop Med Hyg. 2012 Feb;86(2):335-40. doi: 10.4269/ajtmh.2012.11-0346.
Diagnosis of dengue virus (DENV) infection in fatal cases is challenging because of the frequent unavailability of blood or fresh tissues. For formalin-fixed, paraffin-embedded (FFPE) tissues immunohistochemistry (IHC) can be used; however, it may not be as sensitive and serotyping is not possible. The application of reverse transcription-polymerase chain reaction (RT-PCR) for the detection of DENV in FFPE tissues has been very limited. We evaluated FFPE autopsy tissues of 122 patients with suspected DENV infection by flavivirus and DENV RT-PCR, sequencing, and DENV IHC. The DENV was detected in 61 (50%) cases by RT-PCR or IHC. The RT-PCR and sequencing detected DENV in 60 (49%) cases (DENV-1 in 16, DENV-2 in 27, DENV-3 in 8, and DENV-4 in 6 cases). No serotype could be identified in three cases. The IHC detected DENV antigens in 50 (40%) cases. The RT-PCR using FFPE tissue improves detection of DENV in fatal cases and provides sequence information useful for typing and epidemiologic studies.
在致命病例中，登革热病毒（DENV）感染的诊断具有挑战性，因为经常无法获得血液或新鲜组织。对于福尔马林固定、石蜡包埋（FFPE）组织，可以使用免疫组织化学（IHC）；然而，它可能不如敏感，也无法进行血清分型。逆转录-聚合酶链反应（RT-PCR）在 FFPE 组织中检测 DENV 的应用非常有限。我们通过黄病毒和 DENV RT-PCR、测序和 DENV IHC 评估了 122 例疑似 DENV 感染的尸检 FFPE 组织。RT-PCR 或 IHC 在 61 例（50%）病例中检测到 DENV。RT-PCR 和测序在 60 例（49%）病例中检测到 DENV（DENV-1 16 例，DENV-2 27 例，DENV-3 8 例，DENV-4 6 例）。有三例无法确定血清型。IHC 在 50 例（40%）病例中检测到 DENV 抗原。使用 FFPE 组织的 RT-PCR 可提高致命病例中 DENV 的检测率，并提供有用的序列信息，用于分型和流行病学研究。
