Heart and liver are infected in fatal cases of dengue: three PCR based case studies

BMC Infectious Diseases

Table 2 Detection of Dengue virus RNA in different tissue samples obtained at necropsy examination and respective gross and microscopic changes in tissues of fatal cases of dengue

Tissue	Case 1		Case 2		Case 3
	PCR	Macroscopy	PCR	Histology	PCR	Histology
Brain	–		+	Normal	–	Normal
Lungs	+	Congested, Haemorrhagic	*	Congested capillaries	+	Pulmonary oedema, capillary congestion in interstitium
Heart	+	Petechial haemorrages	+	Interstitial oedema with infiltration of neutrophils and lymphocytes	+	Marked interstitial oedema, lymphocytic infiltration in endomyseum
Liver	+	Congested	+	Extensive haemorrhagic necrosis	+	Submassive necrosis, haemorrhagic necrosis
Kidney	+		+	Acute tubular necrosis	–	Acute tubular necrosis
Spleen	–		–	Expansion of red pulp, extravasations of red cells	–	Expansion of red pulp with haemorrhage
Adrenal gland	*		*		+	Early autolysis
Pancreas	*		*		+	Early autolysis
Intestines	+		*
Muscles	*		+	Occasional fibre necrosis, inflammation	+
Skin	+		*		*
Blood	+		*		*

(+) detection of dengue (DEN 2) RNA in tissues, (−-) Dengue RNA not detected, (*) Not tested as tissues samples were not available. In Case 1, histology of tissues were not done

ISSN: 1471-2334