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Chapter 22 : Pathology and Pathogenesis of Virus Infections

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Abstract:

This chapter reviews the cycle of virus infection and discusses the anatomic and physiologic defense mechanisms that are situated at each of the common portals of virus entry. The concepts of cell and tissue tropism are central to an understanding of viral pathogenesis, since the lesions and, subsequently, the clinical features resulting from viral infections typically reflect the cellular and tissue localization of these obligate intracellular parasites. Examples of viral receptors and attachment proteins are provided in the chapter. The chapter concludes with a discussion of virus-induced cellular injury, with emphasis on morphologic features of infection, followed by an organ system-based presentation of virologic syndromes. Many virus infections are cytolytic, since the invading virus induces lethal physiologic or morphologic alterations in the host cell. A section of the chapter examines viral disease pathogenesis from the perspective of major organ systems and important disease syndromes that affect them. Syndrome presentation and major organ involvement in viral infections have been discussed in the chapter. The pathogenesis of two common respiratory disease syndromes, acute respiratory distress syndrome (ARDS) and pneumonia are described. The chapter examines viral disease pathogenesis from three general perspectives: from the perspective of basic concepts of infection and transmission, from the perspective of morphologic aspects of cell injury, and from the perspective of major organ systems and disease syndromes that affect them.

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22

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Figure 1.

(Row 1, left) Enterovirus 71 infection in the brain of a human. A paracrystalline array of picornavirus particles in a neuronal cell is shown. Thin-section electron microscopy. Magnification, ×70,000. Courtesy of Cynthia Goldsmith, Centers for Disease Control and Prevention, Atlanta, Ga. (Row 1, middle and right) Nipah virus infection in the brain of a human. Inclusion of paramyxovirus nucleocapsids (arrows) is present in a neuronal cell. Thin-section electron microscopy. Magnifications, ×4,000 (middle) and 12,000 (right). Courtesy of Cynthia Goldsmith. (Row 2, left and middle) Subacute sclerosing panencephalitis, caused by measles virus infection in the brain of a human. Paramyxovirus nucleocapsids are present in the nucleus of a neuronal cell. Thin-section electron microscopy. Magnifications, ×5,000 (left) and ×40,000 (middle). Courtesy of Cynthia Goldsmith. (Row 2, right) Ebola virus infection in the liver of a human. Filovirus inclusions are present in hepatocytes and virus particles are present in the sinusoid. Thin-section electron microscopy. Magnification,×3,000. Courtesy of Cynthia Goldsmith. (Row 3, left) Small round structured virus (Norwalk-like virus) in a stool culture. Negative-stain electron micrograph. Magnification, ×105,000. Courtesy of Charles Humphrey, Centers for Disease Control and Prevention, Atlanta, Ga. (Row 3, middle) SIV infection in the ileum of a pig-tailed macaque. Characteristic lentivirus particles are visible within an intracytoplasmic vesicle in a Peyer's patch macrophage. Thin-section electron microscopy. Magnification,×42,000. Courtesy of Harold McClure, Yerkes Regional Primate Research Center, Atlanta, Ga. (Row 3, right) Adenovirus infection in the lung of a rhesus macaque monkey. Arrays of adenovirus particles are present within the nucleus of an alveolar epithelial cell. Thin-section electron microscopy. Magnification, ×30,000. Courtesy of Harold McClure.

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22
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Tables

Generic image for table
Table 1.

Natural reservoirs of selected human viral pathogens

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22
Generic image for table
Table 2.

Routes and methods of viral infection

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22
Generic image for table
Table 3.

Selected examples of cell surface receptors used for viral entry

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22
Generic image for table
Table 4.

Viral inclusions useful for histopathologic evaluation

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22
Generic image for table
Table 5.

Syndrome presentation and major organ involvement in viral infections

Citation: O'Neil S, Shieh W, Zaki S. 2002. Pathology and Pathogenesis of Virus Infections, p 307-328. In Kaufmann S, Sher A, Ahmed R (ed), Immunology of Infectious Diseases. ASM Press, Washington, DC. doi: 10.1128/9781555817978.ch22

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