Mesenteric ischemia and bacterial translocation precipitate the intoxication phase of yellow fever.

ABSTRACT: A lethality-defining feature of yellow fever (YF) is the development of "intoxication," a poorly understood late complication of YF that develops in ∼30% of cases characterized by return of fever, lack of viremia, and hemorrhage. Using a hamster model of YF, we worked backwards from observations in humans to examine early events that precipitate the intoxication phase of YF. Severe gastrointestinal damage was a surprising feature of HA-YFV pathology. This was defined by early signs of ischemia followed by ischemia-induced erosion of the gut epithelial barrier, which served as an entry point for luminal bacteria that opportunistically spread via the portal system. Thus, the intoxication phase of YF is a sepsis-like syndrome caused by translocation of bacteria from a damaged intestinal tract

SUBMITTER: Thomazella MV 

PROVIDER: S-EPMC12747459 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature