Histopathological diagnosis of myocarditis in a dengue outbreak in Sri Lanka, 2009

<p>Abstract</p> <p>Background</p> <p>In 2009, an outbreak of dengue caused high fatality in Sri Lanka. We conducted 5 autopsies of clinically suspected myocarditis cases at the General Hospital, Peradeniya to describe the histopathology of the heart and other organs.</p> <p>Methods</p> <p>The diagnosis of dengue was confirmed with specific IgM and IgG ELISA, HAI and RT-PCR techniques. The histology was done in tissue sections stained with hematoxylin and eosin.</p> <p>Results</p> <p>Of the 319 cases of dengue fever, 166(52%) had severe infection. Of them, 149 patients (90%) had secondary dengue infection and in 5 patients, DEN-1 was identified as the causative serotype. The clinical diagnosis of myocarditis was considered in 45(27%) patients. The autopsies were done in 5 patients who succumbed to shock (3 females and 2 males) aged 13- 31 years. All had pleural effusions, ascites, bleeding patches in tissue planes and histological evidence of myocarditis. The main histological findings of the heart were interstitial oedema with inflammatory cell infiltration and necrosis of myocardial fibers. One patient had pericarditis. The concurrent pulmonary abnormalities were septal congestion, pulmonary haemorrhage and diffuse alveolar damage; one case showed massive necrosis of liver.</p> <p>Conclusions</p> <p>The histology supports occurrence of myocarditis in dengue infection.</p

Case Reports- Dengue fever with acute liver failure

A virus belonging to the Flaviviridae group causes dengue haemorrhagic fever. Dengue presenting as acute liver failure is rare. Dengue is endemic in India. The last epidemic of dengue occurred in Delhi in 2003. During this epidemic, 2185 confirmed cases of dengue were reported. Dengue virus serotypes 2 and 3 were responsible for this epidemic. A 19-yr-old male presented to our hospital with the complaints of fever for 12 days, during this epidemic. He was diagnosed as having dengue shock syndrome, stage IV with acute liver failure. He had primary dengue infection. He made complete recovery with supportive management

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Not AvailableAn outbreak of contagious ecthyma was investigated in an organized goat farm in village Tyod in Jaipur district of Rajasthan. The outbreak occurred during the first week of June, 2012 in Beetal goats purchased from Punjab. Within a week, all the goats (24 females and 1 male) were affected with skin lesions accompanied by anorexia and fever. On the basis of clinical symptoms and the extent of gross lesions, animals were categorized into three groups viz., phase I, II and III. Of the 25 Beetal goats, four females and one male showed initial lesions (Phase I) such as papules and pustules at the oral commissures and muzzle. Twelve goats showed moderate lesions (Phase II) of ecthyma. Eight goats were highly emaciated and exhibited anorexia, pyrexia and severe lesions (Phase III) at the oral commissures, muzzle and nostrils as well as haemorrhagic ulcers in buccal mucosa. With the passage of time, the infection spread to other goat flocks of Jakhrana and non-descript goats in which two females of each breed exhibited phase II lesions. Of the 20 kids, only one male kid of Beetal goat was found affected with anorexia, fever and phase I lesions of the disease. The presence of contagious ecthyma in the affected goats was confirmed by specific polymerase chain reaction. Jamunapari, Sirohi, Totapari goats and bucks kept for commercial purposes at the premises did not reveal any clinical signs of the disease. Categorization of the affected animals made it easy to offer an effective treatment as well as prevention of spread of infection in non-affected goats.Not Availabl

Not Available

Not AvailableAn outbreak of contagious ecthyma was investigated in an organized goat farm in village Tyod in Jaipur district of Rajasthan. The outbreak occurred during the first week of June, 2012 in Beetal goats purchased from Punjab. Within a week, all the goats (24 females and 1 male) were affected with skin lesions accompanied by anorexia and fever. On the basis of clinical symptoms and the extent of gross lesions, animals were categorized into three groups viz., phase I, II and III. Of the 25 Beetal goats, four females and one male showed initial lesions (Phase I) such as papules and pustules at the oral commissures and muzzle. Twelve goats showed moderate lesions (Phase II) of ecthyma. Eight goats were highly emaciated and exhibited anorexia, pyrexia and severe lesions (Phase III) at the oral commissures, muzzle and nostrils as well as haemorrhagic ulcers in buccal mucosa. With the passage of time, the infection spread to other goat flocks of Jakhrana and non-descript goats in which two females of each breed exhibited phase II lesions. Of the 20 kids, only one male kid of Beetal goat was found affected with anorexia, fever and phase I lesions of the disease. The presence of contagious ecthyma in the affected goats was confirmed by specific polymerase chain reaction. Jamunapari, Sirohi, Totapari goats and bucks kept for commercial purposes at the premises did not reveal any clinical signs of the disease. Categorization of the affected animals made it easy to offer an effective treatment as well as prevention of spread of infection in non-affected goats.Not Availabl

Not Available

Not AvailableAn outbreak of contagious ecthyma was investigated in an organized goat farm in village Tyod in Jaipur district of Rajasthan. The outbreak occurred during the first week of June, 2012 in Beetal goats purchased from Punjab. Within a week, all the goats (24 females and 1 male) were affected with skin lesions accompanied by anorexia and fever. On the basis of clinical symptoms and the extent of gross lesions, animals were categorized into three groups viz., phase I, II and III. Of the 25 Beetal goats, four females and one male showed initial lesions (Phase I) such as papules and pustules at the oral commissures and muzzle. Twelve goats showed moderate lesions (Phase II) of ecthyma. Eight goats were highly emaciated and exhibited anorexia, pyrexia and severe lesions (Phase III) at the oral commissures, muzzle and nostrils as well as haemorrhagic ulcers in buccal mucosa. With the passage of time, the infection spread to other goat flocks of Jakhrana and non-descript goats in which two females of each breed exhibited phase II lesions. Of the 20 kids, only one male kid of Beetal goat was found affected with anorexia, fever and phase I lesions of the disease. The presence of contagious ecthyma in the affected goats was confirmed by specific polymerase chain reaction. Jamunapari, Sirohi, Totapari goats and bucks kept for commercial purposes at the premises did not reveal any clinical signs of the disease. Categorization of the affected animals made it easy to offer an effective treatment as well as prevention of spread of infection in non-affected goats.Not Availabl