PMC3075397_01
Chest CT-scans of two European patients with hantavirus pulmonary syndrome. The examination showed pronounced diffuse bilateral interstitial infiltrates with pulmonary oedema, together with bilateral dependent atelectasis and moderate pleural effusions in patient 1 (a) and diffuse bilateral alveolar and interstitial infiltrates with dependent consolidation in patient 2 (b)
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Fig1
Thin-cut CT images of the lungs on the third ICU day showed diffuse bilateral alveolar and interstitial infiltrates with dependent consolidation (Fig. 1).
Immunohistochemistry results in lung sections from two fatal cases of hantavirus pulmonary syndrome. The findings were condensed oedematous pulmonary parenchyma with alveolar fibrinous exudate and infiltrates of mononuclear cells (a), whereof a vast majority were CD8+ T lymphocytes (b), and many were holding granules containing granzyme B (c) and T cell restricted antigen-1, TIA-1 (d); this immunophenotype is characteristic of activated cytotoxic T lymphocytes. In contrast, CD4+ helper T lymphocytes (e) were uncommon. Viral antigen was detected in capillary vascular endothelium (f) and in mononuclear cells, here represented by a monocyte (f; inset), using Puumala hantavirus nucleocapsid protein monoclonal antibody (A1C5, Progen Biotechnik GmbH, Heidelberg, Germany). For viral antigen, lung samples from two non-hantavirus patients were used as negative controls (data not shown). Panels (Patient 1 in a-e; original magnification, x 400; and Patient 3 in f; original magnification, x 600) display lung sections from paraffin embedded material. Staining was performed using hematoxylin and eosin (a), and immunoperoxidase technique (b-f)
10096_2010_1141_Fig2_HTML.jpg
PMC3075397_03_10096_2010_1141_Fig2_HTML.jpg
Fig2
The organs were examined for viral antigen, which was found in the vascular endothelium and in mononuclear cells (Fig. 2).
PMC3075397_02
Chest CT-scans of two European patients with hantavirus pulmonary syndrome. The examination showed pronounced diffuse bilateral interstitial infiltrates with pulmonary oedema, together with bilateral dependent atelectasis and moderate pleural effusions in patient 1 (a) and diffuse bilateral alveolar and interstitial infiltrates with dependent consolidation in patient 2 (b)
10096_2010_1141_Fig1_HTML.jpg
PMC3075397_02_10096_2010_1141_Fig1_HTML.jpg
Fig1
Thin-cut CT images of the lungs on the third ICU day showed diffuse bilateral alveolar and interstitial infiltrates with dependent consolidation (Fig. 1).
PMC3075397_03
Immunohistochemistry results in lung sections from two fatal cases of hantavirus pulmonary syndrome. The findings were condensed oedematous pulmonary parenchyma with alveolar fibrinous exudate and infiltrates of mononuclear cells (a), whereof a vast majority were CD8+ T lymphocytes (b), and many were holding granules containing granzyme B (c) and T cell restricted antigen-1, TIA-1 (d); this immunophenotype is characteristic of activated cytotoxic T lymphocytes. In contrast, CD4+ helper T lymphocytes (e) were uncommon. Viral antigen was detected in capillary vascular endothelium (f) and in mononuclear cells, here represented by a monocyte (f; inset), using Puumala hantavirus nucleocapsid protein monoclonal antibody (A1C5, Progen Biotechnik GmbH, Heidelberg, Germany). For viral antigen, lung samples from two non-hantavirus patients were used as negative controls (data not shown). Panels (Patient 1 in a-e; original magnification, x 400; and Patient 3 in f; original magnification, x 600) display lung sections from paraffin embedded material. Staining was performed using hematoxylin and eosin (a), and immunoperoxidase technique (b-f)
10096_2010_1141_Fig2_HTML.jpg
PMC3075397_03_10096_2010_1141_Fig2_HTML.jpg
Fig2
The organs were examined for viral antigen, which was found in the vascular endothelium and in mononuclear cells (Fig. 2).