Custom Search



Infectious Disease Online

Pathology of Respiratory Syncytial Virus Infection

Dr Sampurna Roy MD




Respiratory syncytial virus was first isolated in 1956 by Morris and co-workers who named it "chimpanzee coryza agent".

Shortly thereafter, Chanock and co-workers confirmed that the agent was able to cause respiratory illness in humans.

Respiratory syncytial virus measures from 121 to 300 nm.

It has an RNA genome, and like all members of the paramyxovirus family, the envelop exhibits spokes of glycoprotein.

Respiratory syncytial virus is of worldwide distribution, and primary infection occurs in the very young.


Microscopic features:

In the initial pulmonary infection there is a lymphocytic peribronchiolar infiltrate with some edema of the bronchial walls.  

Necrosis of the cells lining the bronchioles can be seen.

Subsequently there is a proliferative response of the bronchial epithelium.     

There are multinucleated giant cells (in some cases) in bronchi, bronchioles, and alveoli that contain irregular, intracytoplasmic, eosinophilic inclusions surrounded by a clear halo.

The lumen of the small airways becomes narrowed because  of sloughing of necrotic epithelium and an increase in mucin secretion.

Obstruction of airflow occurs, resulting in hyperinflation and trapping of air.

Complete bronchiolar obstruction may lead to atelectasis.

In severe cases there is a prominent interstitial alveolar infiltrate accompanied by edema.


Pathologic Differential Diagnosis

Other viral causes of giant cell pneumonia should be considered, primarily parainfluenza viruses and measles viruses.

Herpes simplex and VZV rarely produce multinucleated cytologic changes in the lung.

Other manifestations of Respiratory syncytial virus infection include otitis media, meningitis, myelitis, and myocarditis.

Confirmation of diagnosis is by clinical laboratory tests on immunohistochemistry.

Related post: Measles


Further reading:

Photographs related to pathology of Respiratory syncytial virus

Respiratory syncytial virus--a comprehensive review

Influenza and respiratory syncytial virus in the elderly

Respiratory syncytial virus pneumonia among the elderly

Respiratory syncytial virus bronchiolitis.

Respiratory syncytial virus infection.

Diagnostic assays for respiratory syncytial virus disease.

The burden of respiratory syncytial virus infection

Viral and Host Factors in Human Respiratory Syncytial Virus




Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






Infectious Disease Online


Pathology Quiz Online 


Paediatric Pathology Online


Pancreatic Pathology Online




Endocrine Pathology Online


Eye Pathology Online


Ear Pathology Online


Cardiac Path Online


Pulmonary Pathology Online


Lung Tumour Online




Nutritional Pathology Online


Environmental Pathology Online


Soft Tissue Tumour Online


GI Path Online-India


Gallbladder Pathology Online


E-book - History of Medicine  


Microscope - Seeing the Unseen





Privacy Policy  

Advertising Policy

Copyright 2019