Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista de Saúde Pública |
Texto Completo: | https://www.revistas.usp.br/rsp/article/view/187660 |
Resumo: | 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. |
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Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosisAutopsyHemorrhagic fevers, viral,etiologyArbovirus infections, mortality 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.Universidade de São Paulo. Faculdade de Saúde Pública2021-06-23info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdftext/xmlhttps://www.revistas.usp.br/rsp/article/view/18766010.11606/s1518-8787.2021055003068Revista de Saúde Pública; Vol. 55 (2021); 41Revista de Saúde Pública; Vol. 55 (2021); 41Revista de Saúde Pública; v. 55 (2021); 411518-87870034-8910reponame:Revista de Saúde Públicainstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/rsp/article/view/187660/173327https://www.revistas.usp.br/rsp/article/view/187660/173326Copyright (c) 2021 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 Sabinohttp://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessAraújo, Leonardo José Tadeu de Gonzalez, Lorenzo Lang Buss, Lewis FletcherGuerra, Juliana MariottiGomez, David SalasFerreira, Camila Santos da Silva Cirqueira, Cinthya SantosGhillardi, FábioWitkin, Steven S. Sabino, Ester Cerdeira2021-06-23T18:25:19Zoai:revistas.usp.br:article/187660Revistahttps://www.revistas.usp.br/rsp/indexONGhttps://www.revistas.usp.br/rsp/oairevsp@org.usp.br||revsp1@usp.br1518-87870034-8910opendoar:2021-06-23T18:25:19Revista de Saúde Pública - Universidade de São Paulo (USP)false |
dc.title.none.fl_str_mv |
Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
title |
Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
spellingShingle |
Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis Araújo, Leonardo José Tadeu de Autopsy Hemorrhagic fevers, viral,etiology Arbovirus infections, mortality |
title_short |
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_sort |
Surveillance of hemorrhagic fever and/or neuroinvasive disease: challenges of diagnosis |
author |
Araújo, Leonardo José Tadeu de |
author_facet |
Araújo, Leonardo José Tadeu de Gonzalez, Lorenzo Lang Buss, Lewis Fletcher Guerra, Juliana Mariotti Gomez, David Salas Ferreira, Camila Santos da Silva Cirqueira, Cinthya Santos Ghillardi, Fábio Witkin, Steven S. Sabino, Ester Cerdeira |
author_role |
author |
author2 |
Gonzalez, Lorenzo Lang Buss, Lewis Fletcher Guerra, Juliana Mariotti Gomez, David Salas Ferreira, Camila Santos da Silva Cirqueira, Cinthya Santos Ghillardi, Fábio Witkin, Steven S. Sabino, Ester Cerdeira |
author2_role |
author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Araújo, Leonardo José Tadeu de Gonzalez, Lorenzo Lang Buss, Lewis Fletcher Guerra, Juliana Mariotti Gomez, David Salas Ferreira, Camila Santos da Silva Cirqueira, Cinthya Santos Ghillardi, Fábio Witkin, Steven S. Sabino, Ester Cerdeira |
dc.subject.por.fl_str_mv |
Autopsy Hemorrhagic fevers, viral,etiology Arbovirus infections, mortality |
topic |
Autopsy Hemorrhagic fevers, viral,etiology Arbovirus infections, mortality |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-06-23 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/187660 10.11606/s1518-8787.2021055003068 |
url |
https://www.revistas.usp.br/rsp/article/view/187660 |
identifier_str_mv |
10.11606/s1518-8787.2021055003068 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rsp/article/view/187660/173327 https://www.revistas.usp.br/rsp/article/view/187660/173326 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf text/xml |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
publisher.none.fl_str_mv |
Universidade de São Paulo. Faculdade de Saúde Pública |
dc.source.none.fl_str_mv |
Revista de Saúde Pública; Vol. 55 (2021); 41 Revista de Saúde Pública; Vol. 55 (2021); 41 Revista de Saúde Pública; v. 55 (2021); 41 1518-8787 0034-8910 reponame:Revista de Saúde Pública instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Revista de Saúde Pública |
collection |
Revista de Saúde Pública |
repository.name.fl_str_mv |
Revista de Saúde Pública - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
revsp@org.usp.br||revsp1@usp.br |
_version_ |
1800221802022043648 |