Fig. 4.

Extrapulmonary pathology of H5N1. A, Reactive hemophagocytosis in pulmonary hilar lymph node and 3 large activated lymphocytes in the center of field. B, Reactive hemophagocytosis in bone marrow. C, Lymphoid depletion in spleen and large activated lymphocytes in inset. D, Skeletal muscle fiber necrosis. E, Microglial nodules with rarefaction and demyelination in cerebral white matter. F, High-power view of microglial nodule with a few axon balls in the lower field and foamy and pigment-laden macrophages (hematoxylin-eosin stain, original magnification ×1000 [A, B, and C inset], ×100 [4E], ×400 [all others]; A-D taken from a patient with H5N1 dying on day 10 [case 3 of Table 2]; E and F taken from a patient with H5N1 dying on day 30 [case 1 of Table 2]).