ABSTRACT
Background: Cardiac damage is frequently referred to in patients with SARS-CoV-2, is usually diagnosed by enzyme elevations, and is generally thought to be due to underlying coronary artery disease. There are references to cardiomyopathies accompanying coronavirus, but there has been no histologic confirmation.Case report: A previously healthy 17 year male old presented in full cardiac arrest to the emergency department after a 2 day history of headache, dizziness, nausea and vomiting. Autopsy demonstrated an enlarged flabby heart with eosinophilic myocarditis. There was no interstitial pneumonia or diffuse alveolar damage. Postmortem nasopharyngeal swabs detected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) known to cause coronavirus disease 2019 (COVID-19). No other cause for the eosinophilic myocarditis was elucidated.Conclusion: Like other viruses, SARS-CoV-2 may be associated with fulminant myocarditis.
Subject(s)
Coronavirus Infections/mortality , Eosinophilia/mortality , Myocarditis/mortality , Myocarditis/virology , Pneumonia, Viral/mortality , Adolescent , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Eosinophilia/complications , Fatal Outcome , Heart Arrest/complications , Heart Arrest/virology , Humans , Male , Myocarditis/complications , Pandemics , Pneumonia, Viral/complications , SARS-CoV-2ABSTRACT
Autopsy findings are presented on six patients in the greater New Orleans area with confirmed novel H1N1 in New Orleans, Louisiana, between the months of September to November 2009. Each case was reviewed for antemortem clinical data as well as pre-existing comorbidities. Results from postmortem gross, histological and bacteriologic analyses are detailed and support the assertion that pathologic findings associated with novel H1N1 are similar to those attributed to previous pandemics, though the rate of bacterial super-infection is variable and may depend on the analytical method of microbiologic testing. The current case series is also remarkable for the associated rate of pulmonary thromboemboli and acute renal failure as potential clinical associations with the current pandemic.
Subject(s)
Forensic Pathology/methods , Influenza A Virus, H1N1 Subtype , Influenza, Human/pathology , Adolescent , Adult , Autopsy , Child , Female , Humans , Influenza, Human/mortality , Male , Middle Aged , New Orleans/epidemiology , Polymerase Chain ReactionSubject(s)
Fever of Unknown Origin/etiology , Malaria, Falciparum/complications , Plasmodium falciparum/isolation & purification , Quinine/administration & dosage , Travel , Adult , Africa , Animals , Endemic Diseases , Female , Humans , Malaria, Falciparum/drug therapy , Pancytopenia/etiology , Risk Assessment , Severity of Illness Index , United StatesABSTRACT
BACKGROUND: Although primary breast cancer is common, metastatic disease to the breast, especially primary gastrointestinal cancer, is rare. Routine pathologic examination may be helpful in determining the true diagnosis, but can be misleading. METHODS: To determine whether a signet ring carcinoma was a primary malignancy of the gastrointestinal tract metastatic to the breast or vice versa, histochemical analysis was performed for Her-2/NEU, gross cystic disease fluid protein-15, estrogen receptor, progesterone, carcinoembryonic antigen, cytokeratin 7, and cytokeratin 20. RESULTS: Positive staining for carcinoembryonic antigen and cytokeratin 20 (and negative staining for the breast cancer antigens), and the clinical criteria favors the diagnosis of gastrointestinal carcinoma metastatic to the mammary gland. CONCLUSIONS: Because the prognosis of therapy for metastatic cancer to the breast differs from that of primary breast cancer, it is imperative that the correct diagnosis be established. Immunohistochemistry for carcinoembryonic antigen and cytokeratin 20 are particularly useful. Metastatic gastrointestinal carcinoma to the breast is a rare lesion but needs to be at least included in the differential diagnosis of breast masses, especially in patients with a history of gastrointestinal cancer.