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Histopathological and ultrastructural analysis of the heart.

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posted on 15.04.2014 by Tiago F. Póvoa, Ada M. B. Alves, Carlos A. B. Oliveira, Gerard J. Nuovo, Vera L. A. Chagas, Marciano V. Paes

(a) Heart of a non-dengue case stained with H.E. and presenting normal aspect. (b and c) Heart sections of dengue cases, stained with HE, showing cardiac injuries, including hemorrhage (He), edema (E), presence of mononuclear infiltrate (Inf) and degeneration of muscle fibers (black star). (d and f) Semi-thin and ultrathin sections of a non-dengue case presenting cardiac fibers (CF) with normal nucleus (N), mitochondria (M), capillaries (Cap) and intercalated discs (ID). (e) Semi-thin section of one dengue case presenting degeneration of cardiac fibers (black star) characterized by absence of nucleus and a diffuse interstitial edema (E) and (g and h) ultrathin sections showing nuclear (white stars) and mitochondria alterations (M) in cardiomyocytes and interstitial edema. Quantitative analysis of hemorrhage (i) and edema (j) observed in dengue (cases 1–4) and non-dengue patients (cont. 1–4), and statistical analysis performed comparing the mean values of each group (dengue patients vs non-dengue patients). Asterisks indicate differences that are statistically significant between control and dengue groups, (*) (P<0.05). Semi-thin and ultrathin sections were stained as described in figure 1, as well as damage quantifications. (Pt) platelets; (EC) endothelial cells.