{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T10:52:11Z","timestamp":1785581531973,"version":"3.56.0"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T00:00:00Z","timestamp":1566518400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatrics International"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Respiratory syncytial virus (<jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content>) infection can be fatal in infants &lt;1\u00a0year after birth. Morphological findings associated with infant death, however, are insufficient, and screening procedures are problematic. The aim of the present study was to establish a postmortem diagnosis of <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> pathogenicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serial forensic autopsies of 55 infants who suddenly died \u22641\u00a0year after birth due to viral pneumonia (<jats:italic>n<\/jats:italic> = 18), bacterial pneumonia (<jats:italic>n<\/jats:italic> = 12), or other diseases and trauma (<jats:italic>n<\/jats:italic> = 25) were assessed. Causes of viral pneumonia determined on immunochemical screening and histological staining of airway effusions consisted of <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> (<jats:italic>n<\/jats:italic> = 8) and other viruses (<jats:italic>n<\/jats:italic> = 10).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Bronchial epithelial and inflammatory cells in the interstitium around bronchioles and alveoli were immunopositive for <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content>. Bronchial epithelium was more frequently positive for <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> (5\/8, 62.5%) than for bacterial pneumonia and other causes of death (7\/47, 14.9%); and intra\u2010alveolar sites were also more frequently positive for <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> pneumonia (3\/8, 37.5%) than for bacterial pneumonia and other causes of death (4\/47, 8.5%). Screening immunoassays and immunohistochemical staining for <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> can serve as an index of <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> infection when serum antibody titers, viral identification and polymerase chain reaction (<jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>) are not informative. Peribronchiolar interstitial <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> positivity was similar between <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> pneumonia (7\/8, 87.5%) and other causes of death (34\/47, 72.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> was the cause of death in only eight infants because <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> infection was difficult to diagnose. Therefore, more deaths associated with <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> need to be investigated. Bronchial epithelium and intra\u2010alveolar cells that are <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> immunopositive might augment <jats:styled-content style=\"fixed-case\">RSV<\/jats:styled-content> pathogenicity in viral pneumonia.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ped.13901","type":"journal-article","created":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T14:03:59Z","timestamp":1559052239000},"page":"781-791","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Immunohistochemical detection of respiratory syncytial virus at autopsy"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3262-3141","authenticated-orcid":false,"given":"Tomoya","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Legal Medicine Osaka City University Medical School Osaka Japan"},{"name":"Medico\u2010legal Consultation and Postmortem Investigation Support Center Osaka City University Medical School Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Tani","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine Osaka City University Medical School Osaka Japan"},{"name":"Medico\u2010legal Consultation and Postmortem Investigation Support Center Osaka City University Medical School Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayoi","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine Osaka City University Medical School Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alissa","family":"Shida","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine Osaka City University Medical School Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiya","family":"Morioka","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine Osaka City University Medical School Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaki","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Legal Medicine Osaka City University Medical School Osaka Japan"},{"name":"Medico\u2010legal Consultation and Postmortem Investigation Support Center Osaka City University Medical School Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.2.179"},{"key":"e_1_2_8_3_1","first-page":"209","article-title":"Systematic review of the biology and medical management of respiratory syncytial virus infection","volume":"48","author":"Black CP","year":"2003","journal-title":"Respir. 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