Pathology of infectious diseases: new agents, opportunistic, neglectable, emergent, reemergent diseases and why not super resistant nosocomial bacteria?

Duarte-Neto, Amaro Nunes

This whole scenario makes the pathology of infectious diseases important, not only in Brazil, but worldwide. For instance, in the case of Zika, it was essential to understand the disease early in the epidemic through the autopsy case report of a conceptus with microcephaly, whose mother acquired the disease in northeastern Brazil. It was possible to describe macroscopy and microscopy of the brain in detail, to observe the agent by immunofluorescence and electron microscopy in the lesions, and to sequence the viral strain obtained in the brain tissue, determining its phylogeny. 3 Subsequently, works by Chimelli et al. 4 and Martines et al. 5 demonstrated that the Zika virus can produce a myriad of lesions in the central and peripheral nervous system due to a change in neuronal development, maturation, and migration, as well as lesions in the maternal placenta. The amount of research accumulated in Zika since the beginning of the epidemic is huge, and the pathology of infectious diseases plays a decisive role. More recently, during the yellow fever epidemic in Brazil from 2017 to 2019, previous and current pathology studies have allowed a better understanding of the pathogenesis of the disease. [6] [7] [8] [9] In our region, where hemorrhagic fevers are endemic (e.g., dengue, leptospirosis, spotted fever, hantavirus, sepsis), the emergence of yellow fever has become a problem for clinicians and epidemiologists. The pathologist's action is decisive for the definition and exclusion of suspected cases, especially fatal ones, allowing accurate knowledge of the mortality rate and the magnitude of the problem.