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Original Research

Post mortem findings in fatal H1N1 infection

Maya Vasaikar, Shivraj Kanthikar, Rajiv Parate, Deepak Shejwal, Smita Bora.


Background: A novel H1N1 influenza virus emerged in April 2009, and rapidly reached pandemic proportion. In India since May 2009 to August 2010, India has reported nearly 37,000 H1N1 cases and 1833 deaths.

Aims & Objective: The present study was undertaken to find the cause of death and various histopathological changes which is responsible for high mortality.

Materials and Methods: This is a retrospective study of five patients who died due to H1N1. Tissues for histopathological examination were received in Pathology department. All the five patients were confirmed for Novel Influenza A (H1N1) by National Institute of Virology.

Results: Four Patients were female in ANC period and a single patient was a young adult. Histopathological examination revealed diffuse alveolar damage (DAD) in both the lungs along with necrotising bronchopneumonia, presence of thrombi in peripheral pulmonary vasculature along with involvement of large vessel was seen in all the cases. Haemophagocytosis was also seen in all the cases.

Conclusion: Thus the main cause of death was due to diffuse alveolar damage (DAD). Thus DAD associated with other complication in lungs and Haemophagocytosis in spleen should raise the suspicion of Influenza A (H1N1) virus.

Key words: Influenza A (H1N1); Diffuse Alveolar Damage (DAD); Hemophagocytosis; Post Mortem Findings

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