Neuropathology of yellow fever autopsy cases

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFRASSETTO, Fernando Pereira
dc.contributor.authorROSEMBERG, Sergio
dc.date.accessioned2023-04-14T18:06:06Z
dc.date.available2023-04-14T18:06:06Z
dc.date.issued2023
dc.description.abstractBackgroundYellow fever is a viral hemorrhagic fever caused by yellow fever virus, a mosquito-borne flavivirus. Despite an effective vaccine, major outbreaks continue to occur around the world. Even though it is not a proven neurotropic virus, neurological symptoms in more severe clinical forms are frequent. The understanding of this apparent paradox is still rarely addressed in literature.MethodsThe brains of thirty-eight patients with yellow fever confirmed by RT-PCR, who underwent autopsy, were analyzed morphologically to identify and characterize neuropathological changes. The data were compared with brains collected from individuals without the disease, as a control group. Both cases and controls were subdivided according to the presence or absence of co-concurrent septic shock, to exclude changes of the sepsis associated encephalopathy. To verify possible morphological differences between the yellow fever cases groups, between the control groups, and between the cases and the controls, we applied the statistical tests Fisher's exact test and chi-square, with p values < 0.05 considered statistically significant.ResultsAll cases and controls presented, at least focally, neuropathological changes, which included edema, meningeal and parenchymal inflammatory infiltrate and hemorrhages, and perivascular inflammatory infiltrate. We did not find an unequivocal aspect of encephalitis. The only parameter that, after statistical analysis, can be attributed to yellow fever was the perivascular inflammatory infiltrate.ConclusionsThe neuropathological findings are sufficient to justify the multiple clinical neurologic disturbances detected in the YF cases. Since most of the parameters evaluated did not show statistically significant difference between cases and controls, an explanation for most of the neuropathological findings may be the vascular changes, consequent to shock induced endotheliopathy, associated with stimulation of the immune system inherent to systemic infectious processes. The statistical difference obtained in yellow fever cases regarding perivascular infiltrate can be can be explained by the immune activation inherent to the condition.eng
dc.description.indexPubMed
dc.description.indexWoS
dc.description.indexScopus
dc.identifier.citationTROPICAL DISEASES TRAVEL MEDICINE AND VACCINES, v.9, n.1, article ID 1, 7p, 2023
dc.identifier.doi10.1186/s40794-022-00187-1
dc.identifier.issn2055-0936
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/53090
dc.language.isoeng
dc.publisherSPRINGERNATUREeng
dc.relation.ispartofTropical Diseases Travel Medicine and Vaccines
dc.rightsopenAccesseng
dc.rights.holderCopyright SPRINGERNATUREeng
dc.subjectYellow Fevereng
dc.subjectAutopsyeng
dc.subjectBraineng
dc.subjectNeuropathologyeng
dc.subjectSepsiseng
dc.subject.otherviruseng
dc.subject.otherpathophysiologyeng
dc.subject.otherpathogenesiseng
dc.subject.otherdysfunctioneng
dc.subject.otheractivationeng
dc.subject.otherdamageeng
dc.subject.otherbraineng
dc.subject.wosPublic, Environmental & Occupational Healtheng
dc.subject.wosInfectious Diseaseseng
dc.subject.wosTropical Medicineeng
dc.titleNeuropathology of yellow fever autopsy caseseng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus1
hcfmusp.contributor.author-fmusphcFERNANDO PEREIRA FRASSETTO
hcfmusp.contributor.author-fmusphcSERGIO ROSEMBERG
hcfmusp.description.articlenumber1
hcfmusp.description.issue1
hcfmusp.description.volume9
hcfmusp.origemWOS
hcfmusp.origem.pubmed36707912
hcfmusp.origem.scopus2-s2.0-85146932758
hcfmusp.origem.wosWOS:000920986300001
hcfmusp.publisher.cityLONDONeng
hcfmusp.publisher.countryENGLANDeng
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