Tissue tropism, pathology and pathogenesis of enterovirus infection

2014/09/11 by Atis Muehlenbachs, Julu Bhatnagar, Sherif R Zaki +1 · 26 citations
Medicine · #Asymptomatic #Biology #Coxsackievirus #Disease #Encephalitis #Enterovirus #Herpesvirus Infections and Treatments #Immunology #Medicine #Myocarditis #Pathogenesis #Pathology #Subclinical infection #Tissue tropism #Tropism #Viral Infections and Immunology Research #Viral gastroenteritis research and epidemiology #Virus

paper · pdf · doi:10.1002/path.4438

openalex publication_date 2014/09/11 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/04

Abstract

Enteroviruses are very common and cause infections with a diverse array of clinical features. Enteroviruses are most frequently considered by practising pathologists in cases of aseptic meningitis, encephalitis, myocarditis and disseminated infections in neonates and infants. Congenital infections have been reported and transplacental transmission is thought to occur. Although skin biopsies during hand, foot and mouth disease are infrequently obtained, characteristic dermatopathological findings can be seen. Enteroviruses have been implicated in lower respiratory tract infections. This review highlights histopathological features of enterovirus infection and discusses diagnostic modalities for formalin-fixed paraffin-embedded tissues and their associated pitfalls. Immunohistochemistry can detect enterovirus antigen within cells of affected tissues; however, assays can be non-specific and detect other viruses. Molecular methods are increasingly relied upon but, due to the high frequency of asymptomatic enteroviral infections, clinical-pathological correlation is needed to determine significance. Of note, diagnostic assays on central nervous system or cardiac tissues from immunocompetent patients with prolonged disease courses are most often negative. Histopathological, immunohistochemical and molecular studies performed on clinical specimens also provide insight into enteroviral tissue tropism and pathogenesis.

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