PMC2904444_01
(a) Time course of AST elevation after allogeneic transplant, (b) hepatic necrosis with intraparenchymal hemmorhage (H & E, 4x), (c) hepatocyte nuclei with marked variation in size, with intranuclear inclusions (H & E, 40x), (d) immunohistochemistry stain:positive for adenovirus (40x), (e) electron micrograph of intranuclear adenovirus particles (14,000x), (F) high-resolution electron micrograph image of adenovirus particles (36,000x).
AH2010-601548.001.jpg
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fig1
Intervention was futile and the patient succumbed in five days, during which, the AST and ALT increased from 80 and 137 U/L to 6163 and 3626 U/L, respectively, (Figure 1(a)).   Autopsy results revealed acute hepatic necrosis secondary to disseminated adenovirus infection and also demonstrated coinfection with Aspergillus nodules identified within the lungs (Figures 1(b) and 1(c)). Immunohistochemical staining for adenovirus was positive in the lamina propria of the small and large intestine, liver, and lung (Figure 1(d)) with confirmation by electron microscopy of the high viral load (Figures 1(e) and 1(f)).