Gj. Nuovo et al., ANALYSIS OF FATAL PULMONARY HANTAVIRAL INFECTION IN NEW-YORK BY REVERSE-TRANSCRIPTASE IN-SITU POLYMERASE CHAIN-REACTION, The American journal of pathology, 148(3), 1996, pp. 685-692
The purpose of this study was to analyze the histological distribution
of polymerase chain reaction (PCR)-amplified hantaviral cDNA in three
cases of fatal hantaviral infection that occurred 2 years ago in Long
Island, NY. The three otherwise healthy patients had a rapid death ch
aracterized by fever and pulmonary failure and were identified from th
e autopsy files at University Hospital, Stony Brook. Six autopsy contr
ols with either no pulmonary disease (three) or fatal pneumonitis of k
nown etiology (three) were also studied. PCR-amplified hantaviral cDNA
was detected in the lung tissue of the three cases and none of the si
x controls using the reverse transcriptase in situ PCR technique. In t
he positive cases, viral RNA was detected in approximately 20% of pneu
mocytes and alveolar endothelial cells as determined with a consensus
and Four Corners-specific primer pair. Infected endothelial cells were
identified in a wide variety of other sites, but at rates much lower
than in the lungs. The selective localization of the viral RNA in many
pneumocytes and pulmonary endothelial cells using a highly, sensitive
PCR-based test demonstrates a correlation between direct viral infect
ion in the lung and the disease process.