АUTHENTICITYOF POSTHUMOUS DIAGNOSIS OF VIRAL PNEUMONIAS

The need for reliable diagnosis of the pathogen (influenza A type (H1 / N1) and other types) in the periods of influenza pandemics prompts the spread of new rapid methods of differential diagnosis in the morphological study of fatal cases of viral and bacterial pneumonia. These pneumonias often have a fulminant course, which not reveals the pathogen in the patient's body and complicates the reliability of posthumous diagnosis. The solution to this problem is possible with the additional conduction of immunohistochemical study of lung autopsy material with the determining the activity of markers pan CK CD34 and CD68. The use of this technique increases the reliability and accelerates the time of the pathoanatomical diagnosis in cases of dispute. The authors of this article analyzed 20 cases of deaths among young people hospitalized with suspected viral or viral-bacterial pneumonia during the epidemic of influenza in Ukraine from December2015to the end of February2016at the National Military Medical Clinical Center (NMMCC). These cases were examined macroscopically and microscopically, with additional staining by the method of setting the periodic acid Schiff reaction and by the method of Van Gyzon. Further, an immunohistochemical study was carried out in the cases with signs of viral damage to determine the activity of the markers pan CK, CD34 and CD68. The obtained results provide an opportunity mor-phologically and topographically to reveal signs of viral damage of various parts of the lungs and indicate the presence of viral agents in different parts of the pulmonary tissue in the investigated cases. Conclusions of the authors of this study coincide with the results of studies of foreign colleagues. At the time when the standard methods of painting allows you to set only the presence of damaged lung tissue (phase diffuse alveolar damage), an additional formulation of the reaction with immunohistochemical markers in the post-humous pathoanatomical diagnosis makes it possible to increase the authenticity of the identification of viral pneu-monia by additional immunohistochemical examination of pulmonary tissue samples by markers CD68, CD34 and pan CK. The use of this technique will also reduce the time of research and diagnosis in the fatal cases of severe fulminant pneumonia and acute respiratory distress syndrome.