Eastern Equine Encephalitis in Children, Massachusetts and New Hampshire,USA, 1970–2010
Michael A. Silverman, John Misasi, Sandra Smole, Henry A. Feldman, Adam B. Cohen, Sandro Santagata, Michael McManus, and Asim A. Ahmed
Author affiliations: Author affiliations: Children's Hospital Boston, Boston, Massachusetts, USA (M.A. Silverman, J. Misasi, H.A. Feldman, S. Santagata, M. McManus, A.A. Ahmed); Department of Public Health, Boston (S. Smole); Massachusetts General Hospital, Boston (A.B. Cohen); Brigham and Women’s Hospital, Boston (S. Santagata)
Figure 3. . . . . . Histopathologic features for patient 12 in a study of children with eastern equine encephalitis (EEE), Massachusetts and New Hampshire, 1970–2010. The postmortem samples of central nervous system tissue were obtained 10 days after the onset of symptoms. A) Hematoxylin and eosin (H&E)–stained section of temporal lobe, showing meningeal inflammation (arrow) (magnification ×200). B) H&E-stained section of midbrain, showing perivascular inflammation (arrow) (magnification ×400). C–F) EEE virus (EEEV) colocalizes with areas of tissue injury in the brain. C) H&E-stained section of the basal ganglia, demonstrating foci of marked tissue rarefaction (arrow) (magnification ×12.5). D) Immunohistochemistry of section adjacent to that shown in panel C; staining of the basal ganglia with EEE immune ascites demonstrates foci of EEEV (arrow) that correspond with areas of tissue rarefaction in panel C (magnification ×12.5). E) Immunohistochemistry with EEE immune ascites demonstrates EEE viral antigens in the thalamus. Specificity for EEEV immunoreactivity of this ascites fluid was confirmed by the lack of staining on control brain specimens (data not shown).
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