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Volume 27, Number 11—November 2021
Dispatch

Fatal Multisystem Inflammatory Syndrome in Adult after SARS-CoV-2 Natural Infection and COVID-19 Vaccination

Heather N. GromeComments to Author , Michael Threlkeld, Steve Threlkeld, Charles Newman, Roosecelis Brasil Martines, Sarah Reagan-Steiner, Michael A. Whitt, Maria Gomes-Solecki, Nisha Nair, Mary-Margaret Fill, Timothy F. Jones, William Schaffner, and John Dunn
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (H.N. Grome, R.B. Martines, S. Reagan-Steiner); Tennessee Department of Health, Nashville, Tennessee, USA (H.N. Grome, M.-M. Fill, T.F. Jones, J. Dunn); Baptist Memorial Health Care, Memphis, Tennessee, USA (M. Threlkeld, S. Threlkeld); Methodist LeBonheur Healthcare, Memphis (M. Threlkeld, S. Threlkeld); Pathology Group of the MidSouth, Germantown, Tennessee, USA (C. Newman); Trumbull Laboratories, Germantown (C. Newman); University of Tennessee Health Science Center, Memphis (M.A. Whitt, M. Gomes-Solecki, N. Nair); Vanderbilt University School of Medicine, Nashville (W. Schaffner)

Main Article

Figure

Histopathologic findings in a fatal case of multisystem inflammatory syndrome in adult after natural severe acute respiratory syndrome coronavirus 2 infection and coronavirus disease vaccination, Tennessee, USA, 2021. A) Lung tissue shows capillaritis characterized by neutrophilic inflammation and necrosis within interalveolar septa (arrowhead). Fibrin and organizing intraluminal microthrombi in small arteries are also seen (arrows). Original magnification 20×. B) Higher magnification of fibrin microthrombus within a lung vessel (arrow). Original magnification 63×. C) Heart tissue shows myocarditis with myocyte necrosis and mixed inflammatory infiltrate. Original magnification 20×. D) Higher magnification cardiac vessel showing microthrombus and perivascular mononuclear inflammatory infiltrate (arrow). Original magnification 40×. E) Stomach tissue shows submucosal microthrombi with perivascular lymphocytic infiltrate. Original magnification 63×. F) Kidney tissue shows multiple fibrin thrombi in glomerular (arrow) and interstitial capillaries (arrow). Original magnification 40×.

Figure. Histopathologic findings in a fatal case of multisystem inflammatory syndrome in adult after natural severe acute respiratory syndrome coronavirus 2 infection and coronavirus disease vaccination, Tennessee, USA, 2021. A) Lung tissue shows capillaritis characterized by neutrophilic inflammation and necrosis within interalveolar septa (arrowhead). Fibrin and organizing intraluminal microthrombi in small arteries are also seen (arrows). Original magnification 20×. B) Higher magnification of fibrin microthrombus within a lung vessel (arrow). Original magnification 63×. C) Heart tissue shows myocarditis with myocyte necrosis and mixed inflammatory infiltrate. Original magnification 20×. D) Higher magnification cardiac vessel showing microthrombus and perivascular mononuclear inflammatory infiltrate (arrow). Original magnification 40×. E) Stomach tissue shows submucosal microthrombi with perivascular lymphocytic infiltrate. Original magnification 63×. F) Kidney tissue shows multiple fibrin thrombi in glomerular (arrow) and interstitial capillaries (arrow). Original magnification 40×.

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Page created: September 02, 2021
Page updated: October 19, 2021
Page reviewed: October 19, 2021
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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