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Tissue tropism, pathology and pathogenesis of enterovirus infection

Atis Muehlenbachs1, Julu Bhatnagar, Sherif R Zaki

  • 1Infectious Diseases Pathology Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA.

The Journal of Pathology
|September 12, 2014
PubMed

Insights

Enteroviruses cause diverse infections, often presenting as meningitis or myocarditis. This review details histopathology, diagnostic pitfalls, and the need for clinical correlation in enterovirus detection.

Area of Science:

  • Pathology
  • Virology
  • Infectious Diseases

Background:

  • Enteroviruses are common viral pathogens causing a wide spectrum of human diseases.
  • Clinical manifestations range from aseptic meningitis and encephalitis to myocarditis and neonatal sepsis.
  • Congenital enterovirus infections and transplacental transmission are recognized, though less common.

Purpose of the Study:

  • To review the histopathological features of enterovirus infections.
  • To discuss diagnostic modalities for formalin-fixed paraffin-embedded tissues.
  • To highlight pitfalls and the importance of clinical-pathological correlation in diagnosing enteroviral infections.

Main Methods:

  • Review of histopathological findings in various tissues affected by enteroviruses.
  • Evaluation of immunohistochemistry for enterovirus antigen detection.
  • Assessment of molecular methods (e.g., PCR) for enteroviral diagnosis.
  • Discussion of diagnostic challenges and limitations.

Main Results:

  • Characteristic dermatopathological findings exist in hand, foot, and mouth disease.
  • Enteroviruses are implicated in lower respiratory tract infections.
  • Immunohistochemistry can detect viral antigens but may lack specificity.
  • Molecular methods are sensitive but require clinical correlation due to asymptomatic infections.
  • Diagnostic assays on CNS or cardiac tissues in immunocompetent patients with prolonged illness are often negative.

Conclusions:

  • Histopathological, immunohistochemical, and molecular techniques aid in diagnosing enterovirus infections.
  • Understanding tissue tropism and pathogenesis is crucial for accurate diagnosis.
  • Clinical-pathological correlation is essential for interpreting diagnostic test results, especially with molecular methods.
  • Awareness of diagnostic pitfalls is necessary for effective patient management.
Keywords:
PCRautopsyenterovirusimmunohistochemistrymeningoencephalitisneonatal and congenital infections

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