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J Infect Dis. 2012 Mar 15;205(6):895-905. doi: 10.1093/infdis/jir861. Epub 2012 Jan 30.

Myocardial injury and bacterial pneumonia contribute to the pathogenesis of fatal influenza B virus infection.

Author information

1
Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA. cdp9@cdc.gov

Abstract

BACKGROUND:

Influenza B virus infection causes rates of hospitalization and influenza-associated pneumonia similar to seasonal influenza A virus infection and accounts for a substantial percentage of all influenza-related hospitalizations and deaths among those aged <18 years; however, the pathogenesis of fatal influenza B virus infection is poorly described.

METHODS:

Tissue samples obtained at autopsy from 45 case patients with fatal influenza B virus infection were evaluated by light microscopy and immunohistochemical assays for influenza B virus, various bacterial pathogens, and complement components C4d and C9, to identify the cellular tropism of influenza B virus, characterize concomitant bacterial pneumonia, and describe the spectrum of cardiopulmonary injury.

RESULTS:

Viral antigens were localized to ciliated respiratory epithelium and cells of submucosal glands and ducts. Concomitant bacterial pneumonia, caused predominantly by Staphylococcus aureus, was identified in 38% of case patients and occurred with significantly greater frequency in those aged >18 years. Pathologic evidence of myocardial injury was identified in 69% of case patients for whom cardiac tissue samples were available for examination, predominantly in case patients aged <18 years.

CONCLUSIONS:

Our findings suggest that bacterial pneumonia and cardiac injury contribute to fatal outcomes after infection with influenza B virus and that the frequency of these manifestations may be age related.

PMID:
22291193
DOI:
10.1093/infdis/jir861
[Indexed for MEDLINE]

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