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. 2017 Nov 22;7:16011. doi: 10.1038/s41598-017-16197-5

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© The Author(s) 2017

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Histological injuries in the peripheral organs of dengue fatal cases (cases 1 and 2). Sections were stained with HE. (a) Hepatic parenchyma showing diffuse steatosis. The hepatocytes present swollen and irregular aspects that are classical cellular alterations of necrotic cells in periportal (PNe) and sinusoidal (SNe) areas. (b) Sinusoidal region showing hepatocytes (H), Kupffer cells (KC) and circulating macrophages (MϕC) with chromatin condensation and cytoplasm with bubble-like protuberances. (c) and (d) Liver sections of a non-dengue case presenting normal hepatic parenchyma (c) and hepatocytes (H) and sinusoidal capillaries (SC) presenting regular aspects of nuclei and cytoplasm (d). (e) Pulmonary parenchyma with relevant hemorrhagic areas, hypercellularity, septal thickening and septal necrosis (SN). (f) Region of septal thickening presenting numerous alveolar macrophages (AM) with loss of membrane integrity and altered heterochromatin. (g) Non-dengue Lung section showing normal alveolar septum (AS) structure and alveolar septal cells with regular characteristics (A - alveoli). (h) Extensive areas of necrosis (Ne), edema (E) and hemorrhage (He) in the cardiac parenchyma. (i) Cardiomyocytes presenting apoptotic nuclei (N) with heterochromatin damages, loss of membrane integrity and striations. (j) and (k) Heart sections of a non-dengue case showing (j) normal aspects of cardiac fibers (CF), conjunctive tissue (CT) and (k) cardiomyocytes with regular chromatin distribution (N - nucleus).