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Abstract
Diagnostic Pathology of Infectious Disease presents a comprehensive, organ-based approach to the effective and accurate diagnosis of infectious diseases. Dr. Richard L. Kradin covers the latest information on H1N1, as well as the use of immunohistochemical stains, PCR, Immunoperoxidase, and other molecular techniques for a current representation of the field. High-quality, full-color illustrations and differential diagnosis tables accompany each lesion so you can quickly identify and diagnose whatever you see. This reference is an invaluable tool for the accurate diagnosis of any infectious disease—from the common to the most challenging.
- Covers the latest techniques in immunohistochemistry and molecular genetics integrated throughout the text for comprehensive information on all investigative contexts relevant to ensuring diagnostic accuracy.
- Emphasizes the host responses critical in differential diagnosis to serve as a second opinion when non-infectious diagnoses mimic and confound the diagnosis of infection.
- Provides a complete visual guide to suspect lesions through superb, high-quality, full-color illustrations of key aspects of various diseases that facilitate the rapid identification of biopsy specimen.
- Presents contents organized by organ as opposed to pathogen to more effectively address diagnostic and management issues.
- Features tables that list differential diagnosis for each lesion for quick summaries of key points in problem areas.
- Highlights morphological characteristics and landmarks of tissue samples throughout the text for easy access to information necessary for signing out specimen.
- Focuses on clinicopathologic features and correlations so you can deal with the diagnostic problems you face every day.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| Half title page | i | ||
| Diagnostic Pathology of Infectious Disease | iii | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | ix | ||
| Acknowledgments | xi | ||
| Table Of Contents | xiii | ||
| 1 Introduction | 1 | ||
| 2 General Principles in the Diagnosis of Infection | 3 | ||
| Introduction | 3 | ||
| Sampling | 3 | ||
| Diagnosing Infection In Situ | 3 | ||
| Potential Limits of Biopsy Interpretation | 4 | ||
| Classification of Patterns of Infection | 4 | ||
| Histochemical Stains | 6 | ||
| Hematoxylin and Eosin | 6 | ||
| Gram Stain | 6 | ||
| Silver Impregnation | 7 | ||
| Fungal Stains | 7 | ||
| Acid-Fast Bacteria Stains | 9 | ||
| Connective Tissue Stains | 9 | ||
| Giemsa Stains | 10 | ||
| Mucicarmine | 10 | ||
| Melanin Stains | 10 | ||
| Viral Inclusion Body Stains | 10 | ||
| Immunohistochemical Methods | 11 | ||
| Molecular Diagnostics | 11 | ||
| In Situ Hybridization | 11 | ||
| Polymerase Chain Reaction | 12 | ||
| REFERENCES | 14 | ||
| 3 The Biopsy in the Diagnosis of Infection: | 17 | ||
| Overview: The Biopsy | 17 | ||
| Approach to the Patient: General Concepts | 18 | ||
| Antimicrobial Therapy | 19 | ||
| Biopsy in the Immunocompromised Host | 19 | ||
| Timeline of Infection | 21 | ||
| Summary | 21 | ||
| REFERENCES | 22 | ||
| 4 Cytopathology of Infectious and Inflammatory Diseases | 23 | ||
| Introduction | 23 | ||
| Processing of Cytologic Samples for Infectious and Inflammatory Diseases | 26 | ||
| Culturing of Fine-Needle Aspirations for Microorganisms | 26 | ||
| Inflammatory Patterns and Associated Pathogens | 28 | ||
| Purulent Inflammatory Response | 28 | ||
| Case 1: Elicitors of the Not So Laudable Pus | 28 | ||
| Case 2: A More Indolent Fibrinopurulent Infection That Goes Bump in the Neck | 30 | ||
| Eosinophils and Allergic Mucin | 33 | ||
| Case 3: The Hepatocellular Carcinoma that Was Not | 35 | ||
| Case 4, 5, and 6: If There Is Allergic Mucin, the Fungi Are Not Invasive | 35 | ||
| Granulomatous Inflammation | 36 | ||
| Cases 7 and 8: A Tale of Two Tubercles | 37 | ||
| Case 9: Willowy Macrophages and AIDS | 39 | ||
| Case 10: Granulomatous Inflammation with Vesiculose Macrophages | 39 | ||
| Granulomatous Inflammation Admixed with Neutrophils | 39 | ||
| Case 11: The Community-Acquired Pneumonia That Wasn’t | 42 | ||
| Case 12: Fluctuant and Full of Fungi | 43 | ||
| Unusual Host Reactions to Infections in the Immunocompromised Patient | 43 | ||
| Patients with Neutropenia or Defective Neutrophils | 43 | ||
| Case 13: Diabetes and Intrabronchial Zygomycosis with Indolent Course | 48 | ||
| Severely Impaired Cell-Mediated Immunity and Diffuse Macrophage Infiltration | 49 | ||
| Case 14: The Young Lady with the Polka-Dotted Macrophages | 49 | ||
| Case 15: The Macrophage Wore Pinstripes | 51 | ||
| Case 16: Overstuffed Macrophages with Lysosome Indigestion | 52 | ||
| Organisms That Elicit Scanty to No Inflammation in Patients with Impaired Cell-Mediated Immunity | 56 | ||
| Cytodiagnosis of Viral Infections | 59 | ||
| Case 17: Intensive Care Unit Vocal Cord Lesion | 60 | ||
| Case 18: Is It Herpes or Molluscum? | 63 | ||
| Case 19: To Immunosuppress or Immunoenhance; That Is the Question! | 64 | ||
| Parasitic Disease in Cytology | 65 | ||
| Case 20: A Worm with the Wanderlust | 67 | ||
| Cases 21 and 22: Parasite Infections Seen in Postmortem Cytology | 68 | ||
| Conclusion | 70 | ||
| APPENDIX Sample Preparation and Staining for Diagnosis of Infectious and Inflammatory Diseases Including Pneumocystis | 70 | ||
| Bronchoalveolar Lavage and Induced Sputum Evaluation for Pneumocystis | 70 | ||
| Preparation of Sputum Samples | 71 | ||
| 5 Ultrastructural Diagnosis of Infection | 77 | ||
| Introduction | 77 | ||
| Electron Microscopy Technique | 77 | ||
| Prions | 78 | ||
| Viral Infections | 79 | ||
| Herpesvirus | 80 | ||
| Varicella Virus | 80 | ||
| Adenovirus | 81 | ||
| Influenza | 81 | ||
| Paramyxovirus | 82 | ||
| Smallpox | 82 | ||
| Hepatitis Viruses | 83 | ||
| Hepatitis A Virus | 83 | ||
| Hepatitis B Virus | 83 | ||
| Parvovirus B19 | 83 | ||
| Enterovirus | 83 | ||
| Viral Gastroenteritis | 84 | ||
| Polyomaviruses | 84 | ||
| Rabies Virus | 84 | ||
| Eastern Equine Encephalitis Virus | 85 | ||
| Human Immunodeficiency Virus | 85 | ||
| Bacterial Infections | 86 | ||
| Gram-Positive Bacteria | 86 | ||
| Gram-Negative Bacteria | 87 | ||
| Mycobacteria | 87 | ||
| Other Important Bacteria | 88 | ||
| Tropheryma whippelii | 88 | ||
| Chlamydia trachomatis | 88 | ||
| Helicobacter pylori | 90 | ||
| Legionella pneumophila | 90 | ||
| Fungal Infections | 90 | ||
| Histoplasma capsulatum | 90 | ||
| Pneumocystis jiroveci | 90 | ||
| Parasitic Infections | 92 | ||
| Acanthamoeba | 92 | ||
| Toxoplasma gondii | 92 | ||
| Cryptosporidium parvum | 94 | ||
| Giardia lamblia | 94 | ||
| Isospora belli | 95 | ||
| Microsporidia | 95 | ||
| Trypanosoma cruzi | 97 | ||
| REFERENCES | 98 | ||
| 6 Ear, Nose, and Throat Infections | 99 | ||
| Bacterial Rhinosinusitis | 99 | ||
| Otitis Media | 100 | ||
| Tonsillitis | 100 | ||
| Peritonsillar Abscess | 101 | ||
| Rhinoscleroma | 102 | ||
| Actinomycosis | 103 | ||
| Botryomycosis | 104 | ||
| Syphilis | 104 | ||
| Tuberculosis | 106 | ||
| Leprosy | 106 | ||
| Oral Candidosis | 107 | ||
| Fungal Rhinosinusitis | 107 | ||
| Paracoccidioidomycosis | 110 | ||
| Sporotrichosis | 112 | ||
| Blastomycosis | 112 | ||
| Coccidioidomycosis | 112 | ||
| Cryptococcosis | 112 | ||
| Histoplasmosis | 112 | ||
| Rhinosporidiosis | 112 | ||
| Mucocutaneous Leishmaniasis | 113 | ||
| Epstein-Barr Virus | 113 | ||
| Herpes Simplex Virus | 115 | ||
| Human Papillomavirus | 115 | ||
| Human Immunodeficiency Virus | 117 | ||
| Mumps | 117 | ||
| REFERENCES | 117 | ||
| 7 Pulmonary Infections | 125 | ||
| Introduction | 125 | ||
| Approach to Sampling for Infection | 125 | ||
| Transbronchial Biopsy | 125 | ||
| Fine-Needle Aspiration Biopsy | 126 | ||
| Transbronchial Needle Aspiration Biopsy | 126 | ||
| Video-Assisted and Open Thoracoscopic Biopsy | 126 | ||
| Handling Lung Biopsy Specimens | 126 | ||
| Pulmonary Injury in Infection | 127 | ||
| Pulmonary Host Response | 127 | ||
| Anatomy of Pulmonary Defense | 127 | ||
| Pulmonary Defenses | 127 | ||
| Patterns of Lung Injury Due to Infection | 128 | ||
| Tracheobronchitis, Bronchiolitis, and Miliary Infection | 128 | ||
| Diffuse Alveolar Damage | 128 | ||
| RNA Viruses | 129 | ||
| Influenza | 129 | ||
| Novel H1N1 Influenza (Swine Flu) | 130 | ||
| Severe Acute Respiratory Syndrome | 131 | ||
| Respiratory Syncytial Virus | 131 | ||
| Parainfluenza | 131 | ||
| Measles | 131 | ||
| DNA Viruses | 132 | ||
| Adenovirus | 132 | ||
| Cytomegalovirus | 133 | ||
| Herpesvirus | 134 | ||
| Varicella-Zoster | 135 | ||
| Hantavirus | 135 | ||
| Other Atypical Pneumonias | 135 | ||
| Mycoplasma Pneumonia | 135 | ||
| Epstein-Barr Virus | 136 | ||
| Pneumocystis jiroveci | 137 | ||
| Bronchiectasis | 138 | ||
| Acute Bronchopneumonia | 139 | ||
| Bacterial Infections | 139 | ||
| Pneumococcal Pneumonia | 140 | ||
| Group A Streptococcal Pneumonia | 140 | ||
| Staphylococcus aureus | 141 | ||
| Gram-Negative Bacteria | 143 | ||
| Klebsiella | 143 | ||
| Lung Abscess Due to Oropharyngeal Aspiration | 144 | ||
| Actinomycosis | 145 | ||
| Nocardia | 145 | ||
| Legionella | 146 | ||
| Rhodococcus equi | 148 | ||
| Tropheryma whippelii (Whipple Disease) | 148 | ||
| Granulomatous Pneumonia | 148 | ||
| Mycobacterial Infections | 148 | ||
| Spectrum of Pulmonary Tuberculous Infection | 151 | ||
| Reactivation Tuberculosis | 152 | ||
| Atypical Mycobacteria | 152 | ||
| Melioidosis | 155 | ||
| Fungal Infection Due to Yeasts | 156 | ||
| Histoplasmosis | 157 | ||
| Blastomyces | 159 | ||
| Cryptococcus | 161 | ||
| Coccidioides immitis | 161 | ||
| Paracoccidioides | 164 | ||
| Candida | 164 | ||
| Hyphate Fungi | 164 | ||
| Aspergillus | 164 | ||
| Immune Disorders Due to Aspergillus Infection | 167 | ||
| Allergic Bronchopulmonary Aspergillosis | 167 | ||
| Bronchocentric Granulomatosis | 167 | ||
| Hypersensitivity Pneumonitis | 168 | ||
| Aspergillus Bronchitis and Chronic Necrotizing Aspergillosis | 168 | ||
| Fungus Balls | 170 | ||
| Angioinvasive Aspergillosis | 171 | ||
| Other Aspergillus Species | 171 | ||
| Other Hyphate Fungi | 172 | ||
| Pseudallescheria (Scedosporium) | 172 | ||
| Fusarium | 172 | ||
| Differential Diagnosis | 175 | ||
| Dematiaceous (Pigmented) Fungi | 175 | ||
| Penicillium marneffei | 176 | ||
| Parasites | 176 | ||
| Protozoa | 176 | ||
| Amebas | 176 | ||
| Toxoplasma | 177 | ||
| Cryptosporidium | 177 | ||
| Microsporidia | 177 | ||
| Nematodes (Roundworms) | 178 | ||
| Dirofilaria | 178 | ||
| Trematodes (Flukes) | 179 | ||
| Paragonimiasis | 179 | ||
| Cestodes (Tapeworms) | 180 | ||
| Microbes Associated with Bioterrorism | 181 | ||
| Anthrax | 181 | ||
| Yersinia pestis (Plague Pneumonia) | 183 | ||
| Francisella tularensis (Tularemia Pneumonia) | 184 | ||
| Pleural Infections | 184 | ||
| REFERENCES | 186 | ||
| 8 Cardiac Infections | 189 | ||
| Introduction | 189 | ||
| The Pathology of Infective Endocarditis | 189 | ||
| The Cardiac Valves | 189 | ||
| Infective Endocarditis | 190 | ||
| Pathogenesis of Infective Endocarditis | 190 | ||
| Hemodynamic Factors That Predispose to the Development of Infectious Endocarditis | 191 | ||
| The Microbiology of Infective Endocarditis | 191 | ||
| Gross Pathology of Infective Endocarditis | 192 | ||
| Microscopic Pathology of Infective Endocarditis | 193 | ||
| Demonstrating Microorganisms in Situ | 193 | ||
| Complications of Infective Endocarditis | 195 | ||
| Embolic Complications | 195 | ||
| Immune Complex Disease | 196 | ||
| Lesions That Mimic Infective Endocarditis | 197 | ||
| Infectious Aneurysms | 198 | ||
| The Pathology of Myocarditis | 200 | ||
| Etiology of Myocarditis | 200 | ||
| The Diagnosis of Myocarditis | 200 | ||
| Viral Myocarditis | 204 | ||
| Pathogenesis of Viral Myocarditis | 204 | ||
| Bacterial Myocarditis | 205 | ||
| Parasitic Infections | 205 | ||
| Fungal Myocarditis | 206 | ||
| Noninfectious Causes of Myocarditis | 206 | ||
| Giant Cell Myocarditis | 206 | ||
| Necrotizing Eosinophilic Myocarditis | 207 | ||
| Drug-Induced Myocarditis | 207 | ||
| Hypersensitivity Myocarditis | 207 | ||
| Toxic Myocarditis | 208 | ||
| Other Inflammatory Forms of Drug-Related Myocarditis | 208 | ||
| Myocarditis Associated with Systemic Disorders | 208 | ||
| Sarcoidosis | 208 | ||
| Other Systemic Disorders | 209 | ||
| Complications and Natural History of Myocarditis | 209 | ||
| The Pathology of Pericarditis | 210 | ||
| Normal Pericardium | 210 | ||
| Etiology of Pericarditis | 210 | ||
| Constrictive Chronic Pericarditis | 211 | ||
| REFERENCES | 211 | ||
| 9 Infections of the Gastrointestinal Tract | 215 | ||
| Introduction | 215 | ||
| Infections of the Esophagus | 215 | ||
| Bacteria | 215 | ||
| Mycobacterium tuberculosis | 215 | ||
| Fungi | 217 | ||
| Candidiasis | 217 | ||
| Aspergillosis | 217 | ||
| Other Fungal Infections | 218 | ||
| Viruses | 218 | ||
| Herpes Simplex Virus Types 1 and 2 | 218 | ||
| Cytomegalovirus | 219 | ||
| Other Viral Infections | 220 | ||
| Human Immunodeficiency Virus | 220 | ||
| Infections of the Stomach | 221 | ||
| Viruses | 221 | ||
| Cytomegalovirus | 221 | ||
| Bacteria | 222 | ||
| Acute Suppurative Gastritis and Emphysematous Gastritis | 222 | ||
| Mycobacterium tuberculosis | 222 | ||
| Actinomycosis | 222 | ||
| Syphilis | 223 | ||
| Fungi | 223 | ||
| Parasites | 224 | ||
| Helicobacter pylori–associated Chronic Gastritis | 224 | ||
| Infections of the Small Bowel | 226 | ||
| Bacteria | 226 | ||
| Escherichia coli | 226 | ||
| Enteropathogenic Escherichia coli | 227 | ||
| Salmonella | 227 | ||
| Vibrio | 228 | ||
| Clostridium | 228 | ||
| Yersinia | 228 | ||
| Mycobacterium tuberculosis | 229 | ||
| Mycobacterium avium-intracellulare Complex | 231 | ||
| Whipple Disease (Tropheryma whippelii) | 231 | ||
| Tropical Sprue | 232 | ||
| Fungi | 233 | ||
| Candida | 234 | ||
| Viruses | 234 | ||
| Enteric Virus Infections | 234 | ||
| Cytomegalovirus | 235 | ||
| Human Immunodeficiency Virus–related Enteropathy | 235 | ||
| Protozoa | 236 | ||
| Flagellates | 236 | ||
| Coccidians | 237 | ||
| Helminths | 238 | ||
| Enterobius vermicularis (Pinworm) | 238 | ||
| Ascaris lumbricoides | 238 | ||
| Ancylostomiasis (Hookworm) | 239 | ||
| Strongyloides stercoralis | 239 | ||
| Capillaria philippinensis (Intestinal Capillariasis) | 239 | ||
| Trematodes | 240 | ||
| Fasciolopsis buski (Intestinal Fluke) | 240 | ||
| Cestodes | 240 | ||
| Infectious Colitis | 241 | ||
| Bacteria | 241 | ||
| Common Histologic Features of Bacterial (Invasive) Colitis | 241 | ||
| Histologic Features Associated with Bacterial Infection | 242 | ||
| Escherichia coli | 242 | ||
| Aeromonas | 242 | ||
| Campylobacter | 242 | ||
| Shigella | 242 | ||
| Salmonella | 242 | ||
| Clostridium difficile | 242 | ||
| Yersinia | 243 | ||
| Mycobacterium tuberculosis | 244 | ||
| Intestinal Spirochetosis | 244 | ||
| Viruses | 244 | ||
| Protozoa | 245 | ||
| Amebiasis | 245 | ||
| Coccidia | 245 | ||
| Other Protozoan Infections | 245 | ||
| Helminths | 246 | ||
| Fungi | 247 | ||
| Sexually Transmitted Diseases | 247 | ||
| Lymphogranuloma Venereum | 247 | ||
| REFERENCES | 248 | ||
| 10 Liver and Bile Duct Infections | 255 | ||
| Viruses | 256 | ||
| Hepatitis A | 256 | ||
| Hepatitis B | 256 | ||
| Virology | 256 | ||
| Pathophysiology | 257 | ||
| Natural History | 257 | ||
| Histopathology | 257 | ||
| Immunohistochemistry | 258 | ||
| Management | 259 | ||
| Viral Mutants | 260 | ||
| Precore and Core Gene Mutations | 260 | ||
| Surface Gene Mutations | 260 | ||
| Polymerase Gene Mutations | 260 | ||
| Post-transplantation Hepatitis B | 260 | ||
| Coinfection with Hepatitis B Virus and Human Immunodeficiency Virus | 260 | ||
| Hepatitis C | 261 | ||
| Virology | 261 | ||
| Natural History | 261 | ||
| Histopathology | 261 | ||
| Management | 263 | ||
| Post-transplantation Hepatitis C | 263 | ||
| Coinfection with Hepatitis C Virus and Human Immunodeficiency Virus | 263 | ||
| Hepatitis D | 263 | ||
| Hepatitis E | 263 | ||
| Epstein-Barr Virus | 264 | ||
| Cytomegalovirus | 264 | ||
| Herpes Simplex Virus | 264 | ||
| Varicella-Zoster Virus | 265 | ||
| Adenovirus | 266 | ||
| Parvovirus B19 | 266 | ||
| Rubella (German Measles) | 266 | ||
| Rubeola (Measles) | 266 | ||
| Severe Acute Respiratory Syndrome Coronavirus | 267 | ||
| Human Immunodeficiency Virus | 267 | ||
| Yellow Fever | 267 | ||
| Dengue | 268 | ||
| Rift Valley Fever | 268 | ||
| Lassa Virus | 268 | ||
| Ebola Virus | 269 | ||
| Marburg Virus | 269 | ||
| Mycobacteria | 269 | ||
| Tuberculosis | 269 | ||
| Mycobacterium avium-intracellulare Complex | 269 | ||
| Leprosy | 269 | ||
| Bacillus Calmette-Guérin | 271 | ||
| Nonmycobacterial Bacteria | 271 | ||
| Pyogenic Liver Abscess | 271 | ||
| Acute Cholangitis | 272 | ||
| Recurrent Pyogenic Cholangitis (Oriental Cholangiohepatitis) | 274 | ||
| Brucellosis | 275 | ||
| Bartonella (Cat-Scratch Disease) | 275 | ||
| Enteric Fever (Typhoid and Paratyphoid Fever) | 276 | ||
| Tularemia | 276 | ||
| Melioidosis | 276 | ||
| Listeriosis | 277 | ||
| Spirochetes | 277 | ||
| Syphilis | 277 | ||
| Leptospirosis | 278 | ||
| Lyme Disease | 278 | ||
| Rickettsia | 278 | ||
| Q fever (Coxiella burnetii) | 278 | ||
| Ehrlichiosis | 279 | ||
| Rocky Mountain Spotted Fever | 279 | ||
| Boutonneuse Fever | 279 | ||
| Fungi | 279 | ||
| Histoplasma | 279 | ||
| Candida | 280 | ||
| Pneumocystis jiroveci | 281 | ||
| Aspergillus | 281 | ||
| Zygomycetes | 281 | ||
| Penicilliosis | 281 | ||
| Cryptococcosis | 281 | ||
| Coccidioidomycosis | 282 | ||
| Blastomycosis | 282 | ||
| Paracoccidioidomycosis (South American Blastomycosis) | 282 | ||
| Microsporidiosis | 282 | ||
| Helminths | 282 | ||
| Schistosomiasis | 282 | ||
| Strongyloides | 283 | ||
| Enterobiasis (Pinworm) | 283 | ||
| Echinococcosis | 284 | ||
| Toxocara | 284 | ||
| Capillariasis | 285 | ||
| Fascioliasis | 285 | ||
| Clonorchiasis | 286 | ||
| Ascariasis | 286 | ||
| Protozoans | 287 | ||
| Amebiasis | 287 | ||
| Malaria | 287 | ||
| Leishmania | 288 | ||
| Toxoplasmosis | 289 | ||
| Cryptosporidiosis | 289 | ||
| REFERENCES | 289 | ||
| 11 Infectious Lymphadenitis | 297 | ||
| Lymphadenitis of Viral or Possible Viral Etiology | 297 | ||
| Infectious Mononucleosis | 297 | ||
| Clinical Features | 297 | ||
| Pathologic Features | 298 | ||
| Differential Diagnosis | 298 | ||
| Cytomegaloviral Lymphadenitis | 299 | ||
| Clinical Features | 299 | ||
| Pathologic Findings | 299 | ||
| 12 Infectious Diseases of the Bone Marrow and Spleen | 325 | ||
| Introduction | 325 | ||
| Patterns of Bone Marrow Response to Infections | 325 | ||
| Hyperplasia | 325 | ||
| Hypoplasia | 326 | ||
| Serous Atrophy (Gelatinous Transformation) | 326 | ||
| Morphologic Dysplasia | 327 | ||
| Lymphoid Aggregates | 327 | ||
| Granulomas | 328 | ||
| Plasmacytosis | 328 | ||
| Hemophagocytosis | 328 | ||
| Bone Marrow Features of Specific Infections | 330 | ||
| Parvovirus B19 Infection | 330 | ||
| Human Immunodeficiency Virus Infection | 330 | ||
| Epstein-Barr Virus Infection | 333 | ||
| Cytomegalovirus Infection | 334 | ||
| Brucellosis | 334 | ||
| Rickettsial Infections | 334 | ||
| Leishmaniasis | 334 | ||
| Pneumocystis | 335 | ||
| Fungal Infections | 335 | ||
| Infections Involving the Spleen | 335 | ||
| Diffuse Red Pulp Reactions to Infection | 335 | ||
| White Pulp Reactions to Infection | 335 | ||
| Mass-Forming and Cystic Splenic Infections | 335 | ||
| REFERENCES | 337 | ||
| 13 Bone Infections | 341 | ||
| Pathophysiology | 341 | ||
| Hematogenous Spread | 341 | ||
| Contiguous Spread | 344 | ||
| Direct Implantation | 344 | ||
| Bacterial Osteomyelitis | 344 | ||
| Bacterial Osteomyelitis from Hematogenous Spread | 344 | ||
| Bacterial Osteomyelitis from Contiguous Spread | 346 | ||
| Bacterial Osteomyelitis from Direct Inoculation | 351 | ||
| Mycobacterial Osteomyelitis | 354 | ||
| Tuberculous Osteomyelitis | 354 | ||
| Non-Tuberculous Mycobacterial Osteomyelitis | 357 | ||
| Lepromatous Osteomyelitis | 358 | ||
| Treponemal Osteomyelitis | 359 | ||
| Skeletal Syphilis | 359 | ||
| Yaws Bone Infection | 361 | ||
| Fungal Osteomyelitis | 362 | ||
| Candida Osteomyelitis | 363 | ||
| Aspergillus Osteomyelitis | 364 | ||
| Cryptococcal Osteomyelitis | 364 | ||
| Sporotrichosis Osteomyelitis | 365 | ||
| Coccidioidomycosis Osteomyelitis | 365 | ||
| Paracoccidioidomycosis Osteomyelitis | 366 | ||
| Histoplasmosis Osteomyelitis | 367 | ||
| Blastomycosis Osteomyelitis | 367 | ||
| Mycetoma | 368 | ||
| Helminthic Osteomyelitis | 368 | ||
| Echinococcal Osteomyelitis | 368 | ||
| Viral Osteomyelitis | 369 | ||
| Variola Osteomyelitis | 370 | ||
| Rubella Osteomyelitis | 370 | ||
| Other Types of Viral Bone Infection | 370 | ||
| Differential Diagnosis of Osteomyelitis | 371 | ||
| REFERENCES | 374 | ||
| 14 Infections of Joints, Synovium-Lined Structures, and Soft Tissue | 377 | ||
| Bacterial Arthritis | 378 | ||
| Gonococcal Arthritis | 380 | ||
| Meningococcal Arthritis | 381 | ||
| Lyme Arthritis (Borreliosis) | 381 | ||
| Tuberculous Mycobacterial Arthritis | 384 | ||
| Non-Tuberculous Mycobacterial Arthritis | 385 | ||
| Fungal Arthritis | 385 | ||
| Candidiasis | 386 | ||
| Cryptococcosis | 386 | ||
| Coccidioidomycosis | 386 | ||
| Blastomycosis | 387 | ||
| Histoplasmosis | 387 | ||
| Sporotrichosis | 387 | ||
| Aspergillosis | 387 | ||
| Mycetoma | 387 | ||
| Viral Arthritis | 388 | ||
| Parvovirus B19 | 388 | ||
| Rubella | 388 | ||
| Hepatitis C | 388 | ||
| Hepatitis B | 388 | ||
| Human Immunodeficiency Virus | 388 | ||
| Alphavirus | 389 | ||
| Reactive Arthritis | 389 | ||
| Acute Rheumatic Fever | 389 | ||
| Post-Streptococcal Reactive Arthritis | 389 | ||
| Soft Tissue Infections | 389 | ||
| Necrotizing Soft Tissue Infections | 390 | ||
| Gas Gangrene | 393 | ||
| Non-Necrotizing Cellulitis | 394 | ||
| Myositis | 394 | ||
| Pyomyositis | 394 | ||
| Psoas Abscess | 395 | ||
| Bacterial Myositis | 395 | ||
| Fungal Myositis | 395 | ||
| Parasitic Soft Tissue Infection | 395 | ||
| Viral Myositis | 396 | ||
| Other Unusual Soft Tissue Infections | 396 | ||
| Mycetoma | 396 | ||
| Chromoblastomycosis and Phaeohyphomycosis | 397 | ||
| Protothecosis | 398 | ||
| Surgical Site Infections | 398 | ||
| Soft Tissue Infection after Military Trauma | 399 | ||
| REFERENCES | 399 | ||
| 15 Genitourinary Infectious Disease Pathology | 403 | ||
| Genitourinary Cutaneous Infections | 403 | ||
| Bacterial Infections | 403 | ||
| Hidradenitis Suppurativa | 404 | ||
| Fournier Gangrene | 404 | ||
| Pseudomonal Cellulitis (Ecthyma Gangrenosum) | 404 | ||
| Mycobacterial Disease | 404 | ||
| Syphilis | 404 | ||
| Chancroid | 405 | ||
| Lymphogranuloma Venereum | 405 | ||
| Granuloma Inguinale (Donovanosis) | 405 | ||
| Fungal Infections | 406 | ||
| Dermatophytosis | 406 | ||
| Pityriasis Versicolor (Tinea Versicolor) | 406 | ||
| Candidiasis | 406 | ||
| Viral Infections | 406 | ||
| Molluscum Contagiosum | 406 | ||
| Herpetic Infections | 406 | ||
| Human Papillomavirus | 407 | ||
| Parasitic Infections | 409 | ||
| Schistosomiasis | 409 | ||
| Scabies and Lice | 409 | ||
| Kidney Infections | 409 | ||
| Acute Interstitial Nephritis | 409 | ||
| Acute Pyelonephritis | 410 | ||
| Focal Bacterial Nephritis (Lobar Nephronia) | 411 | ||
| Emphysematous Pyelonephritis | 411 | ||
| Chronic Pyelonephritis | 412 | ||
| Xanthogranulomatous Pyelonephritis | 412 | ||
| Malakoplakia | 413 | ||
| Megalocytic Interstitial Nephritis | 414 | ||
| Transplant-Related Renal Infections | 414 | ||
| BK Nephropathy | 414 | ||
| Post-Transplantation Lymphoproliferative Disorder | 415 | ||
| Other Infections | 416 | ||
| Mycobacterial Infections | 416 | ||
| Fungal Infections | 418 | ||
| Syphilis | 420 | ||
| Filamentous Bacteria: Actinomycosis and Nocardiosis | 420 | ||
| Rickettsia | 420 | ||
| Leptospirosis | 421 | ||
| Parasitic Infections | 422 | ||
| Malaria | 422 | ||
| Schistosomiasis | 422 | ||
| Hydatidosis | 422 | ||
| Renal Glomerular Disease Caused by Infection | 422 | ||
| Postinfectious (Post-streptococcal) Glomerulonephritis | 422 | ||
| Membranoproliferative Glomerulonephritis | 425 | ||
| Bladder Infections | 426 | ||
| Bacterial Cystitis | 426 | ||
| Fungal Cystitis | 428 | ||
| Viral Infections | 428 | ||
| Herpes Simplex Virus | 428 | ||
| Cytomegalovirus | 428 | ||
| BK Polyomavirus | 428 | ||
| Human Papillomavirus | 428 | ||
| Parasitic Infections | 428 | ||
| Schistosomiasis | 428 | ||
| Trichomoniasis | 429 | ||
| Special Bladder Conditions with an Infectious Association | 429 | ||
| Malakoplakia | 429 | ||
| Encrusted Cystitis | 430 | ||
| Emphysematous Cystitis | 430 | ||
| Infections of the Urethra | 430 | ||
| Infections of the Male Genitourinary System | 430 | ||
| Prostate | 430 | ||
| Epididymis | 430 | ||
| Testis | 431 | ||
| Bacterial | 431 | ||
| Mycobacterial | 431 | ||
| Fungal | 431 | ||
| Viral | 431 | ||
| Mumps | 431 | ||
| Human Immunodeficiency Virus | 431 | ||
| Other Diseases | 433 | ||
| Penis and Scrotum | 433 | ||
| Bacterial Infection | 433 | ||
| Fungal Infection | 435 | ||
| Parasitic Infection | 435 | ||
| Viral Infection | 435 | ||
| REFERENCES | 435 | ||
| 16 Gynecologic Infections | 443 | ||
| Lower Genital Tract | 443 | ||
| Vulva and Vagina | 443 | ||
| Viral Infections | 443 | ||
| Bacterial Infections | 445 | ||
| Fungal Infections | 447 | ||
| Parasitic Infections | 447 | ||
| Larval Infestations | 448 | ||
| Noninfectious Lesions in the Differential Diagnosis of Vulvar and Vaginal Infections | 448 | ||
| Cervix and Vagina | 449 | ||
| Normal Cervical and Vaginal Flora | 449 | ||
| Cervicitis and Vaginitis | 449 | ||
| Common Causes of Symptomatic Cervicitis and Vaginitis | 449 | ||
| Uncommon Causes of Cervicitis and Vaginitis | 452 | ||
| Cervical and Vaginal Infections Causing Scant Inflammation | 453 | ||
| Noninfectious Lesions Mimicking Infections | 453 | ||
| Upper Genital Tract | 453 | ||
| Pelvic Inflammatory Disease | 453 | ||
| Endometrium | 453 | ||
| Endometritis | 454 | ||
| Granulomatous Endometritis | 454 | ||
| Fallopian Tube and Ovary | 454 | ||
| Acute Salpingitis | 454 | ||
| Chronic Salpingitis | 456 | ||
| Granulomatous Salpingitis and Oophoritis | 456 | ||
| Tubo-ovarian Abscess | 457 | ||
| REFERENCES | 458 | ||
| 17 Perinatal Infections | 465 | ||
| Ascending Infections | 465 | ||
| Hematogenously Spread Infections | 466 | ||
| Specific Infectious Organisms | 466 | ||
| Bacterial Infections | 466 | ||
| Group B Streptococci | 466 | ||
| Fusobacterium | 467 | ||
| Listeria monocytogenes | 469 | ||
| Mycobacterium tuberculosis | 469 | ||
| Fungal Infections | 469 | ||
| Candida | 469 | ||
| Parasitic Infections | 469 | ||
| Plasmodium falciparum | 469 | ||
| Schistosomiasis | 470 | ||
| Toxoplasma gondii | 470 | ||
| Trypanosoma cruzi | 473 | ||
| Mycoplasmal and Ureaplasmal Infections | 473 | ||
| Syphilis | 473 | ||
| Viral Infections | 473 | ||
| Cytomegalovirus | 473 | ||
| Herpes Simplex Virus | 474 | ||
| Human Immunodeficiency Virus | 474 | ||
| Parvovirus | 474 | ||
| Rubella | 476 | ||
| Rubeola | 476 | ||
| Varicella | 476 | ||
| Pregnancy-Associated Uterine Infections | 476 | ||
| Fetal and Congenital Infections | 477 | ||
| REFERENCES | 478 | ||
| 18 Infections of the Nervous System | 483 | ||
| Introduction | 483 | ||
| Acute Inflammatory Response | 483 | ||
| Infectious | 483 | ||
| Bacterial | 483 | ||
| Meningitis | 483 | ||
| Abscess | 484 | ||
| Viral | 486 | ||
| Herpes Simplex Virus | 486 | ||
| Varicella-Zoster Virus | 487 | ||
| Eastern Equine Encephalitis Virus | 488 | ||
| Protozoal | 489 | ||
| Toxoplasmosis | 489 | ||
| Fungal | 489 | ||
| Aspergillus | 489 | ||
| Mucormycosis | 490 | ||
| Amebic | 491 | ||
| Noninfectious | 491 | ||
| Infarct | 491 | ||
| Chronic Inflammatory Response | 493 | ||
| Infectious | 493 | ||
| Bacterial | 493 | ||
| Syphilis | 493 | ||
| Viral | 494 | ||
| West Nile Virus | 494 | ||
| Progressive Multifocal Leukoencephalopathy | 495 | ||
| Human Immunodeficiency Virus | 496 | ||
| Cytomegalovirus | 497 | ||
| Subacute Sclerosing Panencephalitis | 497 | ||
| Fungal | 497 | ||
| Candida | 497 | ||
| Helminthic | 498 | ||
| Cysticercosis | 498 | ||
| Rickettsial | 499 | ||
| Noninfectious | 500 | ||
| Vasculitis | 500 | ||
| Paraneoplastic Limbic Encephalitis | 500 | ||
| Lymphoma | 501 | ||
| Extramedullary Plasmacytoma | 502 | ||
| Idiopathic Hypertrophic Pachymeningitis | 502 | ||
| Acute Disseminated Encephalomyelitis | 502 | ||
| Germinoma | 502 | ||
| Granulomatous or Predominantly Histiocytic Inflammatory Pattern | 504 | ||
| Infectious Etiologies | 504 | ||
| Bacteria | 504 | ||
| Tuberculosis | 504 | ||
| Whipple Disease | 505 | ||
| Cerebral Syphilitic Gummas | 506 | ||
| Fungal | 506 | ||
| Dimorphic Fungi | 506 | ||
| Parasitic | 506 | ||
| Schistosomiasis | 506 | ||
| Noninfectious Etiologies | 508 | ||
| Demyelination | 508 | ||
| Rosai-Dorfman Disease | 509 | ||
| Meningiomas with Dense Lymphoplasmacytic Response | 509 | ||
| Langerhans Cell Histiocytosis | 510 | ||
| Sarcoidosis | 510 | ||
| Rheumatoid Meningitis | 510 | ||
| Granulomatous Hypophysitis | 511 | ||
| Foreign Body | 512 | ||
| Minimal or No Inflammatory Response | 512 | ||
| Fungi | 512 | ||
| Cryptococcus | 512 | ||
| Hyphal Organisms in the Immunocompromised Host | 512 | ||
| Viruses | 513 | ||
| Rabies | 513 | ||
| Prions | 513 | ||
| Creutzfeldt-Jakob Disease | 513 | ||
| REFERENCES | 514 | ||
| 19 Skin Infections | 519 | ||
| Diagnostic Approach | 519 | ||
| Bacterial Infections of the Skin | 520 | ||
| Reaction Patterns in Bacterial Skin Infections | 520 | ||
| Specific Disorders | 520 | ||
| Impetigo | 520 | ||
| Staphylococcal Scalded-Skin Syndrome | 521 | ||
| Toxic Shock Syndrome | 521 | ||
| Ecthyma | 522 | ||
| Ecthyma Gangrenosum | 522 | ||
| Erysipelas | 522 | ||
| Erysipeloid Lesion | 523 | ||
| Cellulitis, Including Perianal Streptococcal Dermatitis | 523 | ||
| Clinical Features | 523 | ||
| Histology | 523 | ||
| Etiology and Pathogenesis | 524 | ||
| Necrotizing Fasciitis | 524 | ||
| Pyoderma Vegetans (Blastomycosis-Like Pyoderma) | 524 | ||
| Corynebacterial Infections | 524 | ||
| Diphtheria | 524 | ||
| Erythrasma | 525 | ||
| Trichomycosis | 525 | ||
| Pitted Keratolysis | 525 | ||
| Neisserial Infections | 525 | ||
| Meningococcal Infection | 525 | ||
| Gonococcal Infection | 526 | ||
| Mycobacterial Infections | 526 | ||
| Tuberculosis | 526 | ||
| Primary Inoculation, Tuberculosis Verrucosa Cutis, and Miliary Tuberculosis | 526 | ||
| Cutis Orificialis | 527 | ||
| Lupus Vulgaris, Scrofuloderma, and Tuberculous Gumma | 527 | ||
| Etiology and Pathogenesis of Tuberculosis | 527 | ||
| Atypical Mycobacterial Infections | 527 | ||
| Mycobacterium kansasii | 527 | ||
| Mycobacterium avium-intracellulare | 527 | ||
| Mycobacterium marinum | 528 | ||
| Mycobacterium ulcerans | 528 | ||
| Mycobacterium fortuitum-chelonei | 528 | ||
| Leprosy or Hansen Disease | 528 | ||
| Clinical Features | 528 | ||
| Types of Reactional Leprosy | 529 | ||
| Clinical Pathologic Correlation | 529 | ||
| Early Indeterminate Leprosy | 529 | ||
| Lepromatous Leprosy | 529 | ||
| Borderline Lepromatous Leprosy | 530 | ||
| Mid-borderline Leprosy | 531 | ||
| Borderline Tuberculoid Leprosy | 531 | ||
| Tuberculoid Leprosy | 532 | ||
| Reactions in Leprosy | 532 | ||
| Miscellaneous Bacterial Infections | 534 | ||
| Anthrax | 534 | ||
| Brucellosis | 535 | ||
| Yersiniosis and Plague | 535 | ||
| Granuloma Inguinale | 536 | ||
| Chancroid | 536 | ||
| Rhinoscleroma | 536 | ||
| Tularemia | 536 | ||
| Cat Scratch Disease | 537 | ||
| Bacillary Angiomatosis | 537 | ||
| Malacoplakia | 537 | ||
| Nocardiosis | 538 | ||
| Actinomycosis | 538 | ||
| Botryomycosis | 539 | ||
| Treponemal Diseases | 539 | ||
| Venereal Syphilis | 539 | ||
| Primary and Secondary Syphilis | 539 | ||
| Clinical Features | 539 | ||
| Histopathology | 540 | ||
| Tertiary Syphilis | 540 | ||
| Yaws | 541 | ||
| Pinta | 541 | ||
| Endemic Syphilis | 542 | ||
| Borrelioses | 542 | ||
| Lyme Disease | 542 | ||
| Chlamydial Infections | 542 | ||
| Psittacosis | 543 | ||
| Lymphogranuloma Venereum | 543 | ||
| Rickettsia and Rickettsia-like Organisms | 543 | ||
| Spotted Fever Group | 544 | ||
| Rocky Mountain Spotted Fever | 544 | ||
| Other Rickettsia Species from the Spotted Fever Group | 544 | ||
| Typhus Group | 544 | ||
| Rickettsia-like Organisms | 544 | ||
| Scrub Typhus | 544 | ||
| Q Fever | 545 | ||
| Viral Infections of the Skin | 545 | ||
| Papillomaviridae | 546 | ||
| Verruca Vulgaris | 546 | ||
| Verruca Plana | 546 | ||
| Epidermodysplasia Verruciformis | 547 | ||
| Condyloma Acuminatum | 547 | ||
| Bowenoid Papulosis | 548 | ||
| Herpesviridae | 549 | ||
| Herpes Simplex | 549 | ||
| Clinical Features | 549 | ||
| Histopathology | 549 | ||
| Varicella and Herpes Zoster | 550 | ||
| Varicella | 550 | ||
| Herpes Zoster | 551 | ||
| Cytomegalovirus | 552 | ||
| Epstein-Barr Virus | 552 | ||
| Other Human Herpesviruses | 553 | ||
| Human Herpesvirus 6 | 553 | ||
| Human Herpesvirus 7 | 553 | ||
| Human Herpesvirus 8 | 553 | ||
| Poxviridae | 553 | ||
| Orthopoxvirus | 554 | ||
| Variola (Smallpox) | 554 | ||
| Vaccinia | 554 | ||
| Cowpox | 554 | ||
| Monkeypox | 555 | ||
| Histopathology of Cutaneous Orthopoxvirus Infections | 555 | ||
| Parapoxvirus | 556 | ||
| Paravaccinia (Milker’s Nodule) | 556 | ||
| Ecthyma Contagiosum (Orf) | 556 | ||
| Histopathology of Cutaneous Parapoxvirus Infections | 556 | ||
| Molluscipoxvirus | 556 | ||
| Molluscum Contagiosum | 556 | ||
| Picornaviridae | 558 | ||
| Hand-Foot-and-Mouth Disease | 558 | ||
| Parvoviridae | 558 | ||
| Parvovirus | 558 | ||
| Measles | 559 | ||
| Human Immunodeficiency Virus | 559 | ||
| Clinical Features | 559 | ||
| HIV-Related Dermatoses | 559 | ||
| HIV Seroconversion-Related Rash | 559 | ||
| Immune Reconstitution Inflammatory Syndrome | 559 | ||
| Pruritic Papular Eruption in HIV Disease | 559 | ||
| Eosinophilic Folliculitis | 559 | ||
| Seborrheic Dermatitis | 559 | ||
| Fungal Skin Infections | 560 | ||
| Superficial Mycoses | 560 | ||
| Pityriasis Versicolor | 560 | ||
| Pityrosporum Folliculitis | 560 | ||
| Tinea Nigra | 561 | ||
| White Piedra and Trichosporonosis | 561 | ||
| Black Piedra | 561 | ||
| Dermatophytoses | 561 | ||
| Clinical Types | 562 | ||
| Tinea Barbae | 562 | ||
| Tinea Capitis (Scalp Ringworm) | 562 | ||
| Tinea Favosa | 562 | ||
| Kerion Celsi | 562 | ||
| Tinea Corporis | 562 | ||
| Tinea Cruris | 562 | ||
| Tinea Imbricata (Tokelau) | 562 | ||
| Tinea Manuum | 562 | ||
| Tinea Pedis (Foot Ringworm, Athlete’s Foot) | 562 | ||
| Tinea Unguium | 562 | ||
| Majocchi Granuloma | 563 | ||
| Immunology | 563 | ||
| Histopathology | 563 | ||
| Candidosis | 563 | ||
| Clinical Types | 563 | ||
| Oral Mucous Membrane Infections | 563 | ||
| Genital Infections | 563 | ||
| Cutaneous Infections | 563 | ||
| Candida Onychomycosis | 564 | ||
| Congenital Cutaneous Candidosis | 564 | ||
| Neonatal Candidosis | 564 | ||
| Infantile Gluteal Granuloma | 564 | ||
| Chronic Mucocutaneous Candidiasis | 564 | ||
| Disseminated or Systemic Candidosis | 564 | ||
| Histopathology | 564 | ||
| Etiology and Pathogenesis | 565 | ||
| Systemic Mycoses | 565 | ||
| Blastomycosis | 565 | ||
| Clinical Features | 565 | ||
| Index | 617 | ||
| A | 617 | ||
| B | 618 | ||
| C | 621 | ||
| D | 624 | ||
| E | 624 | ||
| F | 626 | ||
| G | 627 | ||
| H | 628 | ||
| I | 630 | ||
| J | 631 | ||
| K | 631 | ||
| L | 631 | ||
| M | 632 | ||
| N | 634 | ||
| O | 635 | ||
| P | 636 | ||
| Q | 638 | ||
| R | 638 | ||
| S | 639 | ||
| T | 641 | ||
| U | 642 | ||
| V | 642 | ||
| W | 643 | ||
| X | 644 | ||
| Y | 644 | ||
| Z | 644 |