case_images: PMC8387078_01
case_images: Photomicrograph of the lung. A - lung parenchyma with alveolar spaces filled by pink acellular proteinaceous fluid. Also, a large vessel containing mixed inflammatory cell infiltrate and areas of necrosis (H&E, 100X); B - numerous polymorphonuclear leucocytes, nuclear debris, red blood cells, and fungal hyphae with septations (arrows)(H&E 400X); C and D - Grocott-Gomori's Methenamine Silver (GMS) stain special stain demonstrating thick and thin-walled blood vessels with lumen filled with many fungal hyphae and disruption of the vessels wall (200X).
case_images: autopsy-11-e2021313-g01.jpg
case_images: PMC8387078_01_autopsy-11-e2021313-g01.jpg
case_images: gf01
case_images: With informed consent, the patient's autopsy was performed under strict biosafety rules, and histopathological examination was performed (Figure 1). Histopathological examination from the lung revealed diffuse interstitial edema along with acute and chronic inflammation (Figure 1A, B), hematoxylin and eosin). Numerous septate fungal hyphae [red arrow] with acute-angled branching were found invading blood vessels (Figure 1 C, 2AC), Grocott-Gomori's Methenamine Silver), The septate hyphae morphology was consistent with Aspergillus species (Figure 1 D and 2D).
case_images: Photomicrograph of the lung. A, B, and C - demonstrating thick and thin-walled blood vessels with the lumen filled with many fungal hyphae and disruption of the vessels wall (Grocott-Gomori's Methenamine 200X); D - Higher magnification showing several fungal hyphae with acute angle branching and frequent septations morphologically consistent with aspergillosis (Grocott-Gomori's Methenamine 400X).
case_images: autopsy-11-e2021313-g02.jpg
case_images: PMC8387078_01_autopsy-11-e2021313-g02.jpg
case_images: gf02
case_images: Numerous septate fungal hyphae [red arrow] with acute-angled branching were found invading blood vessels (Figure 1 C, 2AC), Grocott-Gomori's Methenamine Silver), The septate hyphae morphology was consistent with Aspergillus species (Figure 1 D and 2D).
case_images: A - Glomeruli capillary filled with fibrin thrombi (arrow) along with acute tubular necrosis (ATN) (H&E x400); B - Necrosis of zone 1 to 3 along with portal track (arrowhead) from the liver (H&E x200); C - Section from spleen showing pan mural necrosis of the vessel wall (arrowhead) along with occasional viable lymphoid germinal center (H&E x400); D - The uterine section shows intramural thrombi in the vessel walls and necrosis and splaying of the smooth muscle fibers (H&E x200).
case_images: autopsy-11-e2021313-g03.jpg
case_images: PMC8387078_01_autopsy-11-e2021313-g03.jpg
case_images: gf03
case_images: However, they did not reveal Invasive aspergillus Infection (Figure 3 AD).