Thursday 7 May 2009
acute encephalitis, predominantly in the brain stem and spinal cord.
Abundant numbers of inflammatory cells with unusual irregularly rod-shaped and lobulated nuclei, mimicking neutrophil morphology, in abscess-like clusters associated with necrosis, as well as in inflammatory infiltrates.
Most of these cells are CD68 positive and CD15 negative.
Viral antigens are found in the cytoplasm of neurons, neuronal processes, and inflammatory cells, most often associated with glial nodules.
The presence of enterovirus 71 can be confirmed by reverse transcription polymerase chain reaction and sequencing.
Immunohistochemistry with CD68 and CD15 may offer some help in the differential diagnosis of brain stem encephalitis caused by enterovirus 71.
Postmortem reverse transcription polymerase chain reaction from brain stem tissues, which have already undergone fixation and histologic processing, can be an important diagnostic tool, which may be of particular value in patients who may have been misdiagnosed clinically.
- enterovirus sp.
Neuropathology in 2 cases of fatal enterovirus type 71 infection from a recent epidemic in the People’s Republic of China: a histopathologic, immunohistochemical, and reverse transcription polymerase chain reaction study. Yang Y, Wang H, Gong E, Du J, Zhao X, McNutt MA, Wang S, Zhong Y, Gao Z, Zheng J. Hum Pathol. 2009 Apr 20. PMID: #19386354#