Adenovirus Type 7 Pneumonia in Children Who Died from Measles-Associated Pneumonia, Hanoi, Vietnam, 2014
Le Thanh Hai, Hoang Ngoc Thach, Ta Anh Tuan, Dao Huu Nam, Tran Minh Dien, Yuko Sato, Toshio Kumasaka, Tadaki Suzuki, Nozomu Hanaoka, Tsuguto Fujimoto, Harutaka Katano, Hideki Hasegawa, Shoji Kawachi, and Noriko Nakajima
Author affiliations: The National Hospital of Pediatrics, Hanoi, Vietnam (L.T. Hai, H.N. Thach, T.A. Tuan, D.H. Nam, T.M. Dien); National Institute of Infectious Diseases, Tokyo, Japan (Y. Sato, T. Suzuki, N. Hanaoka, T. Fujimoto, H. Katano, H. Hasegawa, N. Nakajima); Japanese Red Cross Medical Center, Tokyo (T. Kumasaka); Tomakomai City Hospital, Tomakomai, Japan (S. Kawachi)
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Figure
Figure. Histologic findings from postmortem lung tissues of children who died from measles-associated pneumonia in a pediatric intensive care unit, National Hospital of Pediatrics, Hanoi, Vietnam, January–October 2014. A) Diffuse alveolar damage with hyaline membrane formation (hematoxylin and eosin [H&E] stain, original magnification ×100). B) Necrotizing pneumonia with coagulation necrosis (H&E stain, original magnification ×100). C) Measles giant cell pneumonia. Arrows indicate syncytial cells with intracytoplasmic and intranuclear eosinophilic inclusions that were observed in the thickened alveolar walls (H&E stain, original magnification ×400). D) Adenovirus (AdV) pneumonia with necrotic epithelial cells and intranuclear inclusion bodies. Inset shows eosinophilic inclusion with halo and basophilic inclusion without halo (H&E stain, original magnification ×400). E) Measles nucleoprotein (brown) detected by immunohistochemistical analysis. Inset shows inclusions in syncytial cells with measles nucleoprotein (original magnification ×400). F) AdV antigen (brown) detected by immunohistochemistry (H&E stain, original magnification ×400). Inset: AdV antigens (red) were detected in the epithelial membrane antigen (green)–positive pneumocytes (double immunofluorescence stain, original magnification ×400).
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