Emerging Infectious Disease ISSN: 1080-6059

Astrovirus Encephalitis in Boy with X-linked Agammaglobulinemia

Phenix-Lan Quan, Thor A. Wagner, Thomas Briese, Troy R. Torgerson, Mady Hornig, Alla Tashmukhamedova, Cadhla Firth, Gustavo Palacios, Ada Baisre-De-Leon, Christopher D. Paddock, Stephen K. Hutchison, Michael Egholm, Sherif R. Zaki, James E. Goldman, Hans D. Ochs, and W. Ian Lipkin

Author affiliations: Author affiliations: Columbia University, New York, New York, USA (P.-L. Quan, T. Briese, M. Hornig, A. Tashmukhamedova, G. Palacios, A. Baisre-De-Leon, J.E. Goldman, W.I. Lipkin); University of Washington, Seattle, Washington, USA (T.A. Wagner, T.R. Torgerson, H.D. Ochs); Seattle Children’s Hospital, Seattle (T.A. Wagner, T.R. Torgerson, H.D. Ochs); Pennsylvania State University, Pittsburgh, Pennsylvania, USA (C. Firth); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.D. Paddock, S.R. Zaki); and 454 Life Sciences, Branford, Connecticut, USA (S.K. Hutchison, M. Egholm)

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Figure 4

Immunofluorescence and immunohistochemical analyses with human astrovirus Puget Sound capsid antibodies. A) Indirect double immunofluorescence–stained, formalin-fixed, paraffin-embedded tissue sections from 15-year-old boy with X-linked agammaglobulinemia and astrovirus encephalitis and a control with astrogliosis not caused by astrovirus infection. The sections were stained for the astrocyte marker glial fibrillary acidic protein (GFAP, green) and for viral capsid protein (rabbit serum 1:1,000,

Figure 4. Immunofluorescence and immunohistochemical analyses with human astrovirus Puget Sound capsid antibodies. A) Indirect double immunofluorescence–stained, formalin-fixed, paraffin-embedded tissue sections from 15-year-old boy with X-linked agammaglobulinemia and astrovirus encephalitis and a control with astrogliosis not caused by astrovirus infection. The sections were stained for the astrocyte marker glial fibrillary acidic protein (GFAP, green) and for viral capsid protein (rabbit serum 1:1,000, red). Viral capsid protein is present in hypertropic astrocytes throughout the subcortical white matter and cortex; astrocytes have swollen cell bodies with intense GFAP immunostaining. Blue signal (DAPI) indicates nuclear counterstaining. Original magnification ×100. B) Immunohistochemical localization of viral antigen in a frontal cortex biopsy specimen. Immunoalkaline phosphatase stain with viral capsid antibodies (rabbit serum 1:1,000) and naphthol-fast red with hematoxylin counterstain. Original magnification ×158.

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