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Chronic myopathy associated with coxsackievirus type A9. A combined electron microscopical and viral isolation study

Insights

Researchers identified coxsackievirus A-9 in the muscle tissue of a child with muscular weakness. This finding supports the presence of picornavirus-like particles as actual virions in human muscle.

Area of Science:

  • Virology
  • Pathology
  • Electron Microscopy

Background:

  • Virus-like crystalline structures in human skeletal muscles are frequently observed via electron microscopy.
  • However, isolation and identification of viruses from these structures have been challenging.
  • Previous observations lacked definitive viral identification, leading to speculation about their nature.

Purpose of the Study:

  • To identify the causative agent of muscular weakness and physical retardation in a pediatric patient.
  • To investigate the nature of virus-like particles observed in human skeletal muscle tissue.
  • To confirm the presence of infectious virions within muscle biopsies.

Main Methods:

  • Electron microscopy was performed on muscle tissue from an 11-year-old female patient.
  • The patient exhibited muscular weakness and atrophy of respiratory muscles.
  • Muscle suspension was inoculated into primary human-amnion cells to assess for cytopathic effects, followed by enterovirus typing.

Main Results:

  • Electron microscopy revealed picornavirus-like particles (19-23 nm) infiltrating the patient's muscle.
  • Inoculation of human-amnion cells induced an enterovirus-like cytopathic effect.
  • The isolated virus was identified as coxsackievirus Type A-9 using Lim-Benyesh-Meinick typing serum.

Conclusions:

  • The isolation of coxsackievirus A-9 provides direct evidence for the viral etiology of the observed muscle pathology.
  • This study supports the hypothesis that electron-dense particles seen in muscle are indeed infectious virions.
  • The findings contribute to understanding the role of enteroviruses in human muscle disease.

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