Patients who are at greatest risk of dying experience diffuse or extensive hemorrhage into the skin, mucous membranes, and internal organs, including the cavities of the stomach and intestines. Swelling of the spleen, lymph nodes, kidneys, and brain occurs. In addition, there is usually evidence of interstitial pneumonia and sometimes of pancreatitis and inflammation in the eyes. By the end of the first week of acute symptoms, the patient can bleed freely from the eyes, ears, and nose. Capillary leakage results in vascular collapse.
Patients experience coma and convulsions, followed by respiratory distress, and finally death.
IFA is usually highly misleading for Ebola. Electron microscopy is useful in diagnosing filovirus infection, but does not help distinguish Ebola from the morphologically identical Marburg virus. Thrombocytopenia and abnormal platelet aggregation. Alkaline phosphatase and bilirubin levels are usually normal or only mildly elevated. This is the mortality rate for infections, not just for clinical illness.