Emerging infectious diseases · 2026
Pulmonary Complications in Fatal Yellow Fever, Brazil, 2017-2019.
СтатьяНазвание и аннотация: Перевод в очереди
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Duarte-Neto Amaro N, Dantas Katia C, Ferreira Suzette C, Giugni Fernando R, Cunha Marielton P, Pour Shahab Z, Ledesma Felipe L, Ho Yeh-Li, Nastri Ana C S, Borges Cinthya S C, Rodrigues Fernanda A, Malaque Ceila M S, Sztajnbok Jaques, Mauad Thais, Silva Luiz F F, Saldiva Paulo H N, Dolhnikoff Marisa
Аннотация
Yellow fever (YF) mainly causes severe hepatitis; data on pulmonary pathology remain limited. We investigated respiratory tract pathology in 73 fatal YF cases during the 2017-2019 epidemic in São Paulo, Brazil. All patients died from YF-related fulminant hepatitis. Autopsies revealed frequent tracheitis (91%), pulmonary edema and hemorrhage (100%), diffuse alveolar damage (84%), secondary pneumonia (84%), and bronchoaspiration (60%). Microabscesses, thrombi, and hemophagocytosis were also observed. In 5 cases of vaccine-associated viscerotropic disease, hemorrhage and diffuse alveolar damage were prominent. We detected antigens of YF virus in all cases and viral RNA in 94%. Molecular analysis identified bacterial and fungal pathogens in pneumonia, including gram-negative bacilli, Candida spp., and Aspergillus spp. Electron microscopy did not reveal viral particles in 3 examined cases. Our findings underscore the respiratory tract involvement in severe YF and could help guide diagnosis, intensive care, and public health preparedness in future outbreaks.