Autopsy Findings of a Co-Incidental Postmortem Done on a Confirmed Marburg Virus Patient in Uganda

Background: Marburg virus disease (MVD) is a viral hemorrhagic fever caused by species members of the Marburgvirus genera, family Filoviridae. Clinical manifes-tations resemble those of the other generic Viral Hemorrhagic Fevers—like ebola virus disease (EVD). Because of biosafety and bio-risk concerns arising from the highly in-fectious nature of filoviruses, postmortems are generally contra-indicated. Thus, de-scription of gross pathological and histopathological findings remains poor. Here, we describe the autopsy findings following a rare co-incidental post-mortem done on a 30 male patient, later confirmed to have MVD. Results: (a) External examination revealed body of a male adult in good nutritional state and no external injuries; (b) Internal examination showed mild ascites in the peritoneal cavity with marked pallor of internal organs. The stomach and intestines were filled with blood without any focal organic lesions. There were petechial hem-orrhages in the sub-pleura of both lungs, but no focal lesions in lungs. The other organs had no gross lesions; (c) Microscopic examination of lung, kidney and liver detailed marked intra-alveolar hemorrhages, tubular necrosis in the kidneys and extensive necrosis in the liver with foci of thrombi in major vessels; (d) a diagnosis of massive hemorrhage and disseminated intravascular coagulation (DIC) was made; and immediate cause of death attributed to hemorrhagic shock. Conclusions: MVD is associated with intra-luminal GIT hemorrhage and DIC in major organs (lungs, kidneys, & liver) resulting in focal or extensive necrosis. Malaria co-infection, in absence of early specific biomarkers may have delayed the suspicion for a VHF in this patient. To enhance early detection of VHFs, there is a need for early biomarkers of VHFs.