Emerging Infectious Disease ISSN: 1080-6059

Human Disease from Influenza A (H5N1), Thailand, 2004

Tawee Chotpitayasunondh*, Kumnuan Ungchusak†, Wanna Hanshaoworakul†, Supamit Chunsuthiwat†, Pathom Sawanpanyalert†, Rungruen Kijphati†, Sorasak Lochindarat*, Panida Srisan*, Pongsan Suwan†, Yutthasak Osotthanakorn†, Tanakorn Anantasetagoon†, Supornchai Kanjanawasri†, Sureeporn Tanupattarachai†, Jiranun Weerakul†, Ruangsri Chaiwirattana†, Monthira Maneerattanaporn†, Rapol Poolsavatkitikool†, Kulkunya Chokephaibulkit‡, Anucha Apisarnthanarak§, and Scott F. Dowell¶

Author affiliations: *Queen Sirikit National Institute of Child Health, Bangkok, Thailand; †Ministry of Public Health, Nonthaburi, Thailand; ‡Siriraj Hospital, Bangkok, Thailand; §Thammasat University Hospital, Bangkok, Thailand; ¶International Emerging Infections Program, Nonthaburi, Thailand

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Figure 5

Pathologic findings from a patient (number 6) with confirmed influenza A (H5N1) infection. All slides are stained with hematoxylin and eosin, shown at 40x objective. Panel A shows hyaline membrane formation lining the alveolar spaces of the lung and vascular congestion with a few infiltrating lymphocytes in the interstitial areas. Reactive fibroblasts are also present. Panel B is an area of lung with proliferating reactive fibroblasts within the interstitial areas. Few lymphocytes are seen, and

Figure 5. Pathologic findings from a patient (number 6) with confirmed influenza A (H5N1) infection. All slides are stained with hematoxylin and eosin, shown at 40x objective. Panel A shows hyaline membrane formation lining the alveolar spaces of the lung and vascular congestion with a few infiltrating lymphocytes in the interstitial areas. Reactive fibroblasts are also present. Panel B is an area of lung with proliferating reactive fibroblasts within the interstitial areas. Few lymphocytes are seen, and no viral intranuclear inclusions are visible. Panel C shows fibrinous exudates filling the alveolar spaces, with organizing formation and few hyaline membranes. The surrounding alveolar spaces contain hemorrhage. Panel D is from a section of spleen, showing numerous atypical lymphoid cells scattered around the white pulp. No viral intranuclear inclusions are seen.

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