Division of Infectious Diseases, Hospital das Clínicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil.
Department of Pathology, Faculdade de Medicina, Universidade de Sao Paulo, Brazil; Núcleo de Anatomia Patológica, Instituto Adolfo Lutz, Sao Paulo, Brazil.
Travel Med Infect Dis. 2022 Jul-Aug;48:102351. doi: 10.1016/j.tmaid.2022.102351. Epub 2022 May 7.
Only two naturally occurring human Sabiá virus (SABV) infections have been reported, and those occurred over 20 years ago.
We diagnosed two new cases of SABV infection using metagenomics in patients thought to have severe yellow fever and described new features of histopathological findings.
We characterized clinical manifestations, histopathology and analyzed possible nosocomial transmission. Patients presented with hepatitis, bleeding, neurological alterations and died. We traced twenty-nine hospital contacts and evaluated them clinically and by RT-PCR and neutralizing antibodies. Autopsies uncovered unique features on electron microscopy, such as hepatocyte "pinewood knot" lesions. Although previous reports with similar New-World arenavirus had nosocomial transmission, our data did not find any case in contact tracing.
Although an apparent by rare, Brazilian mammarenavirus infection is an etiology for acute hemorrhagic fever syndrome. The two fatal cases had peculiar histopathological findings not previously described. The virological diagnosis was possible only by contemporary techniques such as metagenomic assays. We found no subsequent infections when we used serological and molecular tests to evaluate close contacts.
仅报告过两例天然发生的人类 Sabiá 病毒（SABV）感染，且均发生在 20 多年前。
我们使用宏基因组学在疑似患有严重黄热病的患者中诊断出两例新的 SABV 感染病例，并描述了组织病理学发现的新特征。
我们描述了临床症状、组织病理学并分析了可能的医院内传播。患者出现肝炎、出血、神经改变并死亡。我们追踪了 29 名医院接触者，并通过 RT-PCR 和中和抗体对其进行了临床和检测。尸检揭示了电子显微镜下独特的特征，如肝细胞“松材线虫结”病变。尽管以前有类似的新世界沙粒病毒报告有医院内传播，但我们的数据在接触者追踪中未发现任何病例。
尽管巴西 mammarenavirus 感染是急性出血热综合征的罕见病因，但仍应引起重视。两例致命病例具有以前未描述的特殊组织病理学发现。仅通过宏基因组学等现代技术才能进行病毒学诊断。我们使用血清学和分子检测评估密切接触者时，未发现后续感染。
