Unraveling the Pathology of the Rare Marburg Virus Disease ThroughAutopsy: A Case Report

Authors

  • Gebremariam Tewelemedhin Gebremariam Forensic Medicine Specialist, Medical Doctor, Division of Forensic Medicine, Rwanda Forensic Institute, Kigali; Rwanda https://orcid.org/0009-0008-4291-6777 (unauthenticated)
  • Charles Karangwa Pharmacist, DEA, PhD, Post Doc Fellowship of Clinical Toxicology, Director General, Rwanda Forensic Institute, Kigali; Rwanda
  • Innocent Nkurunziza Medical Doctor, MPH in Epidemiology, Forensic Medicine Division Manager, Rwanda Forensic Institute, Kigali; Rwanda

DOI:

https://doi.org/10.37506/wh7ayx19

Keywords:

Marburg virus disease; Autopsy findings; Hemorrhagic fever; Multiorgan failure; Febrile illness; Disseminated intravascular coagulation

Abstract

Marburg virus disease is a rare, highly infectious, and fatal illness with limited autopsy-based studies. This case
report details the autopsy findings of a woman who died of Marburg virus disease, offering valuable insights into
the pathogenesis of the disease and its effects on various organ systems. The patient initially presented with fever,
nausea, joint pain, and fatigue, which rapidly progressed to multiorgan failure and disseminated intravascular
coagulopathy. Autopsy revealed extensive hemorrhagic manifestations, including ecchymoses, purpura, and
petechiae, on both external and internal surfaces. Significant hemorrhagic effusions were observed in the body
cavities, and multiple organs showed signs of congestion, hemorrhage, and edema.This case report contributes to
the limited autopsy-based literature on Marburg virus disease, emphasizing the importance of considering it in the
differential diagnosis of febrile illnesses in endemic areas and the need for further comprehensive autopsy studies
to guide targeted interventions.

Author Biographies

  • Gebremariam Tewelemedhin Gebremariam, Forensic Medicine Specialist, Medical Doctor, Division of Forensic Medicine, Rwanda Forensic Institute, Kigali; Rwanda

    Forensic Medicine Specialist, Medical Doctor, Division of Forensic Medicine, Rwanda Forensic Institute,
    Kigali; Rwanda

  • Charles Karangwa, Pharmacist, DEA, PhD, Post Doc Fellowship of Clinical Toxicology, Director General, Rwanda Forensic Institute, Kigali; Rwanda

    Pharmacist, DEA, PhD, Post Doc Fellowship of Clinical Toxicology, Director General,
    Rwanda Forensic Institute, Kigali; Rwanda

  • Innocent Nkurunziza, Medical Doctor, MPH in Epidemiology, Forensic Medicine Division Manager, Rwanda Forensic Institute, Kigali; Rwanda

    Medical Doctor, MPH in Epidemiology, Forensic Medicine Division Manager, Rwanda Forensic Institute, Kigali; Rwanda

References

Kortepeter MG, Dierberg K, Shenoy ES, Cieslak TJ: Marburg virus disease: A summary for clinicians. International Journal of Infectious Diseases. 2020, 99:233–42. 10.1016/j.ijid.2020.07.042

Letafati A, Fakhr SSH, Najafabadi AQ, Karami N, Karami H: Marburg Virus Disease: A Narrative Review. Health Science Reports. 2025, 8:e70669. 10.1002/hsr2.70669

Islam MR, Akash S, Rahman MM, Sharma R: Epidemiology, pathophysiology, transmission, genomic structure, treatment, and future perspectives of the novel Marburg virus outbreak. International Journal of Surgery. 2023, 109:36–8. 10.1097/JS9.0000000000000096

Cuomo-Dannenburg G, McCain K, McCabe R, et al.: Marburg virus disease outbreaks, mathematical models, and disease parameters: a systematic review. The Lancet Infectious Diseases. 2024, 24:e307–17. 10.1016/S1473-3099(23)00515-7

Abir MH, Rahman T, Das A, et al.: Pathogenicity and virulence of Marburg virus. Virulence. 2022, 13:609–33. 10.1080/21505594.2022.2054760

Uppala PK, Karanam SK, Kandra NV, Edhi S: Marburg virus disease: Emerging threat, pathogenesis, and global public health strategies. World J Virol. 2025, 14:. 10.5501/wjv.v14.i2.103576

Thakur N, Cui S, Patel KA, et al.: Marburg Virus Outbreak and a New Conspiracy Theory: Findings from a Comprehensive Analysis and Forecasting of Web Behavior. Computation. 2023, 11:234. 10.3390/computation11110234

Baby B, Rajendran R, Nair MM, Raghavan RP: Sagacious Perceptive on Marburg Virus Foregrounding the Recent Findings:A Critical Review. IDDT. 2022, 22:e100522204513. 10.2174/1871526522666220510103618

Chakraborty S, Chandran D, Mohapatra RK, et al.: Marburg Virus Disease – A Mini-Review. J Exp Bio & Ag Sci. 2022, 10:689–96. 10.18006/2022.10(4).689.696

Sword J, Lee JH, Castro MA, et al.: Computed Tomography Imaging for Monitoring of Marburg Virus Disease: a Nonhuman Primate Proof-Of-Concept Study. Microbiol Spectr. 2023, 11:e03494-22. 10.1128/spectrum.03494-22

Francis DL, Reddy SSP, Logaranjani A, Sai Karthikeyan SS, Rathi M: Marburg Virus Disease: Pathophysiology, Diagnostic Challenges, and Global Health Preparedness Strategies. Annals of Global Health. 2025, 91:24. 10.5334/aogh.4671

Marzi A, Feldmann H: Marburg Virus Disease: Global Threat or Isolated Events? The Journal of Infectious Diseases. 2023, 228:103–5. 10.1093/infdis/jiad161

El-khamissy T, Abdo M: The Problematic Diseases of viral Hemorrhagic Fever: Insights into Ebola, Marburg, and Dengue Fever Viruses. ERU Research Journal. 2024, 0:0–0. 10.21608/erurj.2024.240845.1079

Hunter N, Rathish B: Marburg Virus Disease. In: StatPearls. StatPearls Publishing: Treasure Island (FL); 2025.

Siddig EE, Ndembi N, Ahmed A, Muvunyi CM: Immunogenicity, Pathogenesis, and Host’s Immuno-Responses to Marburg Virus Infection. Pathogens. 2025, 14:323. 10.3390/pathogens14040323

Roy B, Robinson J, Banerjee I: Marburg Virus: A comprehensive examination of a critical pathogen. J Adv Intern Med. 2024, 13:70–7. 10.3126/jaim.v13i2.74078

Edward M, Scott GY, John W, Rajabu ME, Mahulu E, Saidu Musa S, Don Eliseo LI: Marburg virus outbreak in Tanzania: A threat to global health security. Public Health Challenges. 2023, 2:e140. 10.1002/puh2.140

Kalungi S, Kyobe Bosa H, Wayengera M, Odida M: Autopsy Findings of a Co-Incidental Postmortem Done on a Confirmed Marburg Virus Patient in Uganda. 2025. 10.20944/preprints202506.1738.v1

Haque, Z, Kamrujjaman, M, Alam, MS, Biswas, MHA: Marburg Virus and Risk Factor Among Infected Population: A Modeling Study. MJMS. 2024, 18:141–65. 10.47836/mjms.18.1.09

Srivastava S, Sharma D, Kumar S, et al.: Emergence of Marburg virus: a global perspective on fatal outbreaks and clinical challenges. Front Microbiol. 2023, 14:1239079. 10.3389/fmicb.2023.1239079

Okesanya OJ, Manirambona E, Olaleke NO, et al.: Rise of Marburg virus in Africa: a call for global preparedness. Annals of Medicine & Surgery. 2023, 85:5285–90. 10.1097/MS9.0000000000001257

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Published

2026-04-23

How to Cite

Unraveling the Pathology of the Rare Marburg Virus Disease ThroughAutopsy: A Case Report. (2026). Indian Journal of Forensic Medicine & Toxicology, 20(2), 23-28. https://doi.org/10.37506/wh7ayx19