Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis
ABSTRACT OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtaine...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2021-06-01
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| Series: | Revista de Saúde Pública |
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| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100232&tlng=en |
| _version_ | 1818978718070079488 |
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| author | Leonardo José Tadeu de Araújo Lorenzo Lang Gonzalez Lewis Fletcher Buss Juliana Mariotti Guerra David Salas Gomez Camila Santos da Silva Ferreira Cinthya Santos Cirqueira Fábio Ghillardi Steven S. Witkin Ester Cerdeira Sabino |
| author_facet | Leonardo José Tadeu de Araújo Lorenzo Lang Gonzalez Lewis Fletcher Buss Juliana Mariotti Guerra David Salas Gomez Camila Santos da Silva Ferreira Cinthya Santos Cirqueira Fábio Ghillardi Steven S. Witkin Ester Cerdeira Sabino |
| author_sort | Leonardo José Tadeu de Araújo |
| collection | DOAJ |
| description | ABSTRACT OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy. |
| first_indexed | 2024-12-20T16:48:05Z |
| format | Article |
| id | doaj.art-21097c0949eb40b8993fd7a198ebe6f5 |
| institution | Directory Open Access Journal |
| issn | 1518-8787 |
| language | English |
| last_indexed | 2024-12-20T16:48:05Z |
| publishDate | 2021-06-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Revista de Saúde Pública |
| spelling | doaj.art-21097c0949eb40b8993fd7a198ebe6f52022-12-21T19:32:53ZengUniversidade de São PauloRevista de Saúde Pública1518-87872021-06-015510.11606/s1518-8787.2021055003068Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosisLeonardo José Tadeu de Araújohttps://orcid.org/0000-0002-5427-4053Lorenzo Lang Gonzalezhttps://orcid.org/0000-0002-1972-4004Lewis Fletcher Busshttps://orcid.org/0000-0002-9009-9301Juliana Mariotti Guerrahttps://orcid.org/0000-0002-0326-7187David Salas Gomezhttps://orcid.org/0000-0001-9227-2211Camila Santos da Silva Ferreirahttps://orcid.org/0000-0002-0386-5486Cinthya Santos Cirqueirahttps://orcid.org/0000-0002-3719-5505Fábio Ghillardihttps://orcid.org/0000-0001-9875-2339Steven S. Witkinhttps://orcid.org/0000-0002-3502-3929Ester Cerdeira Sabinohttps://orcid.org/0000-0003-2623-5126ABSTRACT OBJECTIVE To evaluate the performance of post mortem laboratory analysis in identifying the causes of hemorrhagic fever and/or neuroinvasive disease in deaths by arbovirus infection. METHODS Retrospective cross-sectional study based on the differential analysis and final outcome obtained in patients whose samples underwent laboratory testing for arboviruses at the Pathology Center of the Adolfo Lutz Institute, in São Paulo, Brazil. RESULTS Of the 1355 adults clinically diagnosed with hemorrhagic fever and/or neuroinvasive disease, the most commonly attributed cause of death and the most common final outcome was dengue fever. Almost half of the samples tested negative on all laboratory tests conducted. CONCLUSION The failure to identify the causative agent in a great number of cases highlights a gap in the diagnosis of deaths of unknown etiology. Additional immunohistochemical and molecular assessments need to be added to the post-mortem protocol if all laboratory evaluations performed fail to identify a causative agent. While part of our findings may be due to technical issues related to sample fixation, better information availability when making the initial diagnosis is crucial. Including molecular approaches might lead to a significant advancement in diagnostic accuracy.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100232&tlng=enAutopsy. Hemorrhagic FeversViraletiology. Arbovirus Infectionsmortality |
| spellingShingle | Leonardo José Tadeu de Araújo Lorenzo Lang Gonzalez Lewis Fletcher Buss Juliana Mariotti Guerra David Salas Gomez Camila Santos da Silva Ferreira Cinthya Santos Cirqueira Fábio Ghillardi Steven S. Witkin Ester Cerdeira Sabino Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis Revista de Saúde Pública Autopsy. Hemorrhagic Fevers Viral etiology. Arbovirus Infections mortality |
| title | Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
| title_full | Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
| title_fullStr | Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
| title_full_unstemmed | Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
| title_short | Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
| title_sort | surveillance of hemorrhagic fever and or neuroinvasive disease challenges of diagnosis |
| topic | Autopsy. Hemorrhagic Fevers Viral etiology. Arbovirus Infections mortality |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102021000100232&tlng=en |
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