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Vaccinia Virus Infection & Temporal Analysis of Virus Gene Expression: Part 1
Published on: April 8, 2009
Monkeypox virus: histologic, immunohistochemical and electron-microscopic findings
1Marshfield Clinic, Marshfield, WI 54449, USA. bayer-garner.ilene@marshfieldclinic.org
Journal of Cutaneous Pathology
|January 22, 2005
Summary
Human monkeypox, a viral zoonosis, presents with distinct skin lesions and fever. Histological examination of biopsies reveals characteristic viral cytopathic effects and inflammation, aiding in diagnosis.
Area of Science:
- Pathology
- Virology
- Dermatology
Background:
- Human monkeypox is an emerging viral zoonosis originating in Africa, recently identified in the US.
- Initial symptoms include skin eruptions, fever, diaphoresis, and rigors.
- Clinical progression involves lesions evolving from papules to pustules and eschars.
Purpose of the Study:
- To describe the histological, immunohistochemical, and electron-microscopic features of human monkeypox skin lesions.
- To aid in the differential diagnosis of monkeypox from other viral exanthems.
Main Methods:
- Analysis of three cutaneous biopsy specimens from two patients with PCR-proven monkeypox.
- Utilized histology, immunohistochemistry, and electron microscopy.
Main Results:
- Histological findings mirror clinical progression, showing basal keratinocyte degeneration, spongiosis, and epidermal necrosis.
- Inflammation involves epidermis, vascular plexuses, eccrine units, and follicles.
- Viral cytopathic effects include multinucleated syncytial keratinocytes; viral antigen detected in epidermal and follicular cells.
Conclusions:
- Histological differential diagnosis includes herpes simplex virus, varicella, and smallpox.
- Herpes simplex virus can be differentiated by all methods.
- Varicella and smallpox are best differentiated by PCR assay for the monkeypox virus gene.
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