Difference between revisions of "Microorganisms"

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'''Microorganisms''' show-up every once in a while.  It is essential to know 'em.
'''Microorganisms''' show-up every once in a while.  It is essential to know 'em.


==Microorganisms==
=Microorganisms=
 
==Fungi==
{| class="wikitable"
{| class="wikitable sortable"
|-
|-
! Name (disease)
! Name (disease)
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! Image
! Image
|-
|-
| Aspergillus (aspergillosis)
| Aspergillus ([[aspergillosis]])
| Fungi
| Fungi
| ?
| ?
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| Fruiting heads when aerobic
| Fruiting heads when aerobic
| ? Immunosuppression
| ? Immunosuppression
| <ref>APBR P.682.</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref>
| [http://commons.wikimedia.org/w/index.php?title=File:Pulmonary_aspergillosis.jpg Aspergillus (WC)], [http://commons.wikimedia.org/wiki/File:Pulmonary_aspergillosis_cytology.jpg Aspergillus cytology (WC)]
| [[Image:Pulmonary_aspergillosis.jpg|thumb|center|150px| Aspergillus. (WC)]]
|-
|-
| Zygomycota (zygomycosis);<br>''more specific''<br>Mucorales (mucormycosis)
| Zygomycota ([[zygomycosis]]);<br>''more specific''<br>Mucorales (mucormycosis)
| Fungi
| Fungi
| ?
| ?
| '''Branching hyphae with variable width'''
| '''Branching hyphae with variable width'''
| ?
| ?
| Granulomata assoc.
| [[Granulomata]] assoc.
| Diabetes, immunodeficient
| Diabetes, immunodeficient
| <ref>APBR P.682.</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref>
| [http://granuloma.homestead.com/ZygoHE_02.jpg Mucormycosis (homestead.com)], [http://commons.wikimedia.org/wiki/File:Zygomycosis.jpg Zygomycosis (WC)]
| [[Image:Zygomycosis.jpg |thumb|center|150px| Zygomycosis. (WC)]]
|-
|-
| Coccidioides, usually C. immitis<br>(coccidioidomycosis)
| Coccidioides, usually C. immitis<br>(coccidioidomycosis)
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| Other?
| Other?
| Immunodeficient
| Immunodeficient
| <ref>APBR P.682.</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref>
| [http://pathmicro.med.sc.edu/mycology/cocc3.jpg Coccidioidomycosis (med.sc.edu)] [http://commons.wikimedia.org/wiki/File:Coccidioides_immitis_on_Sabouraud%27s_medium.jpg C. immitis (WC)]
| [http://pathmicro.med.sc.edu/mycology/cocc3.jpg Coccidioidomycosis (med.sc.edu)] [[Image:Coccidioides_immitis_on_Sabouraud%27s_medium.jpg |thumb|center|150px|C. immitis (WC)]]  
|-
|-
| Histoplasma (histoplasmosis)
| Histoplasma ([[histoplasmosis]])
| Fungi
| Fungi
| 2-5 micrometers
| 2-5 micrometers
| Spherical
| Spherical
| GMS
| [[GMS]]
| '''Intracellular (unlike candida), granulomata'''
| '''Intracellular (unlike candida), granulomata'''
| Source: soil with bird droppings
| Source: soil with bird droppings
| <ref>APBR P.682.</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref>
| [http://commons.wikimedia.org/wiki/File:Histoplasma_pas-d.jpg Histoplasmosis (WC)]
| [[Image:Histoplasma_pas-d.jpg|thumb|center|150px| Histoplasmosis. (WC)]]
|-
|-
| Blastomyces (Blastomycosis)
| Blastomyces ([[blastomycosis]])
| Fungi
| Fungi
| 5-15 micrometres
| 5-15 micrometres
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| Granulomas, '''broad-based budding yeast'''
| Granulomas, '''broad-based budding yeast'''
| Habitat: Northeast America, Africa
| Habitat: Northeast America, Africa
| <ref>APBR P.682.</ref><ref>[http://pathmicro.med.sc.edu/mycology/mycology-6.htm http://pathmicro.med.sc.edu/mycology/mycology-6.htm]</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref><ref>[http://pathmicro.med.sc.edu/mycology/mycology-6.htm http://pathmicro.med.sc.edu/mycology/mycology-6.htm]</ref>
| [http://pathmicro.med.sc.edu/mycology/blast1.jpg Blastomyces]
| [[Image:Blastomycosis_cropped.JPG | thumb|center|150px|Blastomyces. (WC)]]
|-
|-
| Paracoccidioides (Paracoccidioidomycosis)
| Paracoccidioides ([[paracoccidioidomycosis]])
| Fungi
| Fungi
| 6-60 micrometres
| 6-60 micrometres
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| '''Multiple budding "steering wheel" appearance'''
| '''Multiple budding "steering wheel" appearance'''
| Clinical???
| Clinical???
| <ref>APBR P.682.</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref>
| [http://commons.wikimedia.org/wiki/File:Paracoccidioides_brasiliensis_01.jpg P. brasiliensis (WC)].
| [[Image:Paracoccidioides_brasiliensis_01.jpg |thumb|center|150px|P. brasiliensis (WC)]]
|-
|-
| Pneumocystis jirovecii (Pneumocystis carinii pneumonia; abbrev. PCP)
| Pneumocystis jirovecii ([[pneumocystis carinii pneumonia]]; abbrev. PCP)
| Fungi (previously thought to be a protozoan)
| Fungi (previously thought to be a protozoan)
| 7-8 micrometres
| 7-8 micrometres
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| GMS
| GMS
| Usually in clusters of '''alveolar casts with a honeycomb appearance'''
| Usually in clusters of '''alveolar casts with a honeycomb appearance'''
| HIV/AIDS associated
| [[HIV]]/AIDS associated
| <ref>APBR P.684.</ref>
| <ref name=Ref_APBR684>{{Ref APBR|684}}</ref>
| [http://commons.wikimedia.org/wiki/File:Pneumocystosis_carinii_of_lung_in_AIDS_959_lores.jpg PCP (WC)]
| [[Image:Pneumocystosis_carinii_of_lung_in_AIDS_959_lores.jpg|thumb|center|150px| PCP. (WC)]]
|-
|-
| Cryptococcosis
| Cryptococcus ([[cryptococcosis]])
| Fungi  
| Fungi  
| 5-15 micrometres
| 5-15 micrometres
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| '''Prominent (i.e. thick polysaccharide) capsule'''
| '''Prominent (i.e. thick polysaccharide) capsule'''
| HIV/AIDS associated, most common CNS fungus
| HIV/AIDS associated, most common CNS fungus
| <ref>APBR P.682.</ref>
| <ref name=Ref_APBR682>{{Ref APBR|682}}</ref>
| [http://commons.wikimedia.org/wiki/File:Cryptococcosis_of_lung_in_patient_with_AIDS_Methenamine_silver_stain_963_lores.jpg Crytococcosis - methenamine silver (WC)], [http://commons.wikimedia.org/wiki/File:Cryptococcosis_of_lung_in_patient_with_AIDS._Mucicarmine_stain_962_lores.jpg Crytococcosis - mucicarmine (WC)].
| [[Image:Cryptococcosis_of_lung_in_patient_with_AIDS._Mucicarmine_stain_962_lores.jpg |thumb|center|150px| Crytococcosis - mucicarmine (WC)]]
|}
|}
Notes:
Notes:
*'''Bold''' text = key features.
*'''Bold''' text = key features.


==Fungi==
=Fungi=
{{Main|Fungi}}
*There are lots of 'em.  Below are a few of 'em.
*There are lots of 'em.  Below are a few of 'em.


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===Tissue invasive fungi===
===Tissue invasive fungi===
Typically:<ref>CM 17 Apr 2009.</ref>
Typically:<ref>CM 17 Apr 2009.</ref>
*Mucor
*Mucor.
*Aspergillus
*Aspergillus.


==Histoplasmosis==
===List===
*''Histoplasma capulatum'' - primative fungus, typical location: lung.
*[[Histoplasmosis]].
** Often in yeast form in tissue 2-5 micrometres.<ref>WMSP P.103.</ref>
*[[Coccidioidomycosis]].
** Nice bright red on PAS-D - [http://en.wikipedia.org/wiki/File:Histoplasma_pas-d.jpg histoplasmosis (wikipedia.org)].
*[[Pneumocystis pneumonia]].
*[[Cryptococcus]].
*[[Cryptosporidiosis]].
*[[Candidiasis]].
*[[Blastomycosis]].
*[[Mucormycosis]].


==Coccidiomycosis==
=Worms & stuff=
*''Coccidioides immitis'' - fungus, from soil, typical locations: lung, oral cavity.<ref>WMSP P.3.</ref>
** Forms spherules 60-80 micrometres in size.<ref>WMSP P.103.</ref>
** [http://commons.wikimedia.org/wiki/File:Mature_spherule_with_endospores_of_Coccidioides_immitis_PHIL_480_lores.jpg Coccidioides (commons.wikimedia.org)].


==Pneumocystis pneumonia (PCP) ==
==Schistosomiasis==
*''Pneumocystis jirovecii'' (used to be called ''Pneumocystis carinii'') - fungus (that used to be considered a parasite), typical location: lung.
:''See [[Urine cytopathology]]''.
**Clinical: Opportunistic infection. May have subtle finding on chest x-ray.
===General===
**"Dented ping-pong ball" appearance;<ref>WMSP P.103.</ref> - remember '''P'''C'''P''' = '''p'''ing-'''p'''ong.
*Trematode, i.e. type of worm.
**Approximately 7-8 micrometres in size - [http://commons.wikimedia.org/wiki/File:Pneumocystosis_carinii_of_lung_in_AIDS_959_lores.jpg PCP (WP)].  [http://commons.wikimedia.org/w/index.php?title=Special%3ASearch&search=Pneumocystis+carinii&go=Go Several images are here (WC)].


==Cryptococcus==
*Due to:
*Usually ''C. neoformans'', fungus - opportunistic infection, typical location: lung.
**''Schistosoma mansoni''.
*Most common fungus seen in CSF specimens.<ref>APBR P.682.</ref>
**''Schistosoma haematobium''.
**''Schistosoma japonicum''
*''S. haematobium'' infection associated with [[squamous cell carcinoma of the urinary bladder]].
**Classically presents with hematuria.


Appearance:
===Microscopic===
*Yeast:
Features of ova (''S. haematobium''):<ref>URL: [http://path.upmc.edu/cases/case622/dx.html http://path.upmc.edu/cases/case622/dx.html]. Accessed on: 26 January 2012.</ref>
**Round/ovoid 5-15 micrometres (may resemble Histoplasma or Candida -- but often larger).
* Elliptical ~140 micrometres max dimension.
**Thick mucopolysacchardie capsule + refractile centre.<ref>APBR P.682.</ref>
* "Spike" approx. the size of a [[PMN]].  
**"Tear drop-shapped" budding pattern (useful to differentiate from Blastomyces, Histoplasma).<ref>APBR P.682.</ref>


Images:
====Images====
*[http://commons.wikimedia.org/wiki/File:Cryptococcosis_of_lung_in_patient_with_AIDS._Mucicarmine_stain_962_lores.jpg Micrograph of crytococcosis - mucicarmine stain (WC)].
<gallery>
*[http://commons.wikimedia.org/wiki/File:Cryptococcosis_of_lung_in_patient_with_AIDS_Methenamine_silver_stain_963_lores.jpg Micrograph of crytococcosis - methenamine silver stain (WC)].
Image:Schistosomiasis_haematobia.jpg | Schistosomiasis haematobia. (WC)
Image:Schistosoma japonicum (1) histopathology.JPG | Schistosoma japonicum. (WC/KGH)
Image:Schistosoma japonicum (2) histopathology.JPG | Schistosoma japonicum. (WC/KGH)
Image:Schistosoma japonicum (3) histopathology.JPG | Schistosoma japonicum. (WC/KGH)
Image:Schistosoma_-_intermed_mag.jpg | Schistosoma eggs - intermed. mag. (WC/Nephron)
Image:Schistosoma_-_very_high_mag.jpg | Schistosoma eggs - very high mag. (WC/Nephron)
</gallery>
www:
*[http://path.upmc.edu/cases/case622.html Schistosomiasis - several images (upmc.edu)].
*[http://path.upmc.edu/cases/case622/images/fig08.jpg Comparison of Schistosome eggs (upmc.edu/Lancet)].
 
==Toxoplasma==
===General===
*Common CNS infection.
**''Toxoplasma gondii'' - pathogenic; causes ''toxoplasmosis''.
*Previously classified as a ''protozoa''.
*A [[TORCH infection]].
 
===Microscopic===
General:
*Tachyzoites (Invasive form):
**Crescent-shaped organisms that are 2-3μm wide by 4-8μm long.
*Bradyzoites:
**Are founded within the tissue cysts and are shorter than tachyzoites.
*Oocysst:
**Ovoid shape that measures 10μm to 12μm and contains four sporozoites.  


==Cryptosporidiosis==
*Histopathological features depend on location in body.
*Uniform spherical nodules 2-4 micrometres in diameter, typical location - GI tract brush border.
*Tip-off -- '''key feature''' -- bluish staining of brush border
*Images:
**[http://www.co.hennepin.mn.us/portal/site/HCInternet/menuitem.3f94db53874f9b6f68ce1e10b1466498/?vgnextoid=bab360a6bb9fc010VgnVCM1000000f094689RCRD Micrograph of cryptosporidium in the gallbladder (hennepin.mn.us)].
**[http://www.tulane.edu/~wiser/protozoology/notes/images/cp_path.gif Schematic picture of cryptosporidium & bowel (tulane.edu)].
**[http://www.brown.edu/Courses/Digital_Path/systemic_path/GI/cryptosporidiosis.html Micrograph of cryptosporidiosis (brown.edu)].


Notes:
====Lymph node====
*Cryptosporidium parvum?<ref>[http://www.dpd.cdc.gov/dpdx/HTML/Cryptosporidiosis.htm http://www.dpd.cdc.gov/dpdx/HTML/Cryptosporidiosis.htm]</ref>
LN features:<ref name=Ref_ILNP113>{{Ref ILNP|113}}</ref>
*Reactive germinal centers (pale areas - larger than usual).
**Often poorly demarcated - due to loose epithelioid cell clusters at germinal center edge - '''key feature'''.
*Epithelioid cells - perifollicular & intrafollicular.
**Loose aggregates of histiocytes (do not form round granulomas):
***Abundant pale cytoplasm.
***Nucleoli.
*Monocytoid cells (monocyte-like cells) - in cortex & paracortex.
**Large cells in islands/sheets '''key feature''' with:
***Abundant pale cytoplasm - '''important'''.  
***Well-defined cell border - '''important'''.
***Singular nucleus.  
**Cell clusters usually have interspersed neutrophils.


==Candidiasis==
Images (lymph node):
*Commonly ''Candida albicans'' - yeast (fungus), locations: oral cavity, vagina.
*[http://commons.wikimedia.org/wiki/File:Toxoplasmosis_lymphadenopathy_-_low_mag.jpg Toxoplasmosis - low mag. (WC)].
*''Dimorphic'' - seen in two forms:
*[http://commons.wikimedia.org/wiki/File:Toxoplasmosis_lymphadenopathy_-_high_mag.jpg Toxoplasmosis - high mag. (WC)].
**Pseudohyphae<ref>WMSP P.3.</ref> - collections of many ''C. albicans'' cells in a branching pattern.
**Yeast form - single cells, 10 to 12 micrometres in diameter, gram positive.<ref>[http://pathmicro.med.sc.edu/mycology/mycology-3.htm http://pathmicro.med.sc.edu/mycology/mycology-3.htm]</ref>
*Stains: PAS, methenamine silver.
*Images:
**[http://pathmicro.med.sc.edu/mycology/candi4.jpg Candida (pseudohyphae) - methenamine silver (med.sc.edu)].


==Blastomycosis==
====CNS====
*Usually ''Blastomyces dermatitidis'' - fungus.
CNS features:<ref>URL: [http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm]. Accessed on: 19 October 2010.</ref>
*May be in the oral cavity.<ref>WMSP P.3.</ref>
*Granular appearing ball ~ 2x the size of resting lymphocyte.
*Histology = '''B'''road-based budding yeast -- is '''B'''lastomyces.<ref name=pmid12375640>PMID 12375640</ref>
**The interface between two separating fungi, i.e. fungi in the process of reproducing, is very large.
*Images:
**[http://commons.wikimedia.org/wiki/File:Blastomycosis_cropped.JPG Blastomycosis (wikimedia.org)].
**[http://www.pathguy.com/lectures/blastomycosis.jpg Blastomycosis - budding (pathguy.com)].
**[http://www.lahey.org/Medical/InfectiousDiseases/ID_Blastomycosis.asp Blastomycosis - with broad budding (lahey.org)].


=====Images (CNS)=====
<gallery>
Image:Toxoplasmosis_-_cropped_-_very_high_mag.jpg | CNS toxoplasmosis - very high mag. (WC)
Image:Toxoplasmosis_-_ihc_-_very_high_mag.jpg | CNS toxoplasmosis - IHC - very high mag. (WC)
</gallery>
www:
*[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm CNS toxoplasmosis (ouhsc.edu)].
*[http://moon.ouhsc.edu/kfung/jty1/Composites/FND5IE01-Toxoplasmosis-Micro.htm CNS toxoplasmosis (ouhsc.edu)].
*[http://path.upmc.edu/cases/case350.html Toxoplasmosis - several images (upmc.edu)].


==Mucormycosis==
====Heart====
===General===
Features:
*Causative organism: Mucorales.
*Intramuscular organisms.
**Kingdom: Fungi.
**AKA ''Zygomycota'' (zygomycosis).
*Assoc. with diabetes, immunodeficiency.


===Histology===
DDx:
Features:<ref>APBR P.682.</ref>
*[[Chagas disease]]. (???)
*Branching hyphae variable width.
*Granulomata associated.


Image:
Images (heart):
*[http://granuloma.homestead.com/ZygoHE_02.jpg Mucormycosis (homestead.com)].
*[http://path.upmc.edu/cases/case160.html Toxoplasmosis (upmc.edu)].


===IHC===
*IHC for toxoplasma.<ref>URL: [http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm]. Accessed on: 19 October 2010.</ref>


==Worms==
==Strongyloidiasis==
===General===
*Causes by worm ''Strongyloides  stercoralis''.
*High case mortality rate ~ 70%.<ref name=pmid15337730>{{Cite journal  | last1 = Lim | first1 = S. | last2 = Katz | first2 = K. | last3 = Krajden | first3 = S. | last4 = Fuksa | first4 = M. | last5 = Keystone | first5 = JS. | last6 = Kain | first6 = KC. | title = Complicated and fatal Strongyloides infection in Canadians: risk factors, diagnosis and management. | journal = CMAJ | volume = 171 | issue = 5 | pages = 479-84 | month = Aug | year = 2004 | doi = 10.1503/cmaj.1031698 | PMID = 15337730 }}</ref>
*May present after years of latency due to immune suppression.<ref name=pmid11528578>{{Cite journal  | last1 = Siddiqui | first1 = AA. | last2 = Berk | first2 = SL. | title = Diagnosis of Strongyloides stercoralis infection. | journal = Clin Infect Dis | volume = 33 | issue = 7 | pages = 1040-7 | month = Oct | year = 2001 | doi = 10.1086/322707 | PMID = 11528578 }}</ref>


==Strongyloides==
Location:
*Lung?
*Lung. (???)


===Microscopic===
Features:
Features:
*Long worms.
*Long worms.
*~10-15 micrometers wide.
*~10-15 micrometers wide.
====Images====
<gallery>
Image:Strongyloides_stercoralis_larva.jpg | Strongyloides. (WC)
</gallery>
www:
*[http://www.totallyfreeimages.com/121316/This-micrograph-reveals-adult-strongyloides-nematodes-located-am Strongyloides (CDC/totallyfreeimages.com)].
*[http://www.sciencephoto.com/media/116331/enlarge Strongyloides (sciencephoto.com)].


==Echinococcus==
==Echinococcus==
*Echinococcus granulosus.
*Several species - most common: ''Echinococcus granulosus''.
*Causes ''hydatid disease'' in the liver.
*Causes ''[[hydatid disease]]'' in the [[liver]].


===Microscopic===
Features:
Features:
*Hooklets.
*Laminated wall +/- calcification.<ref name=Ref_PBPoD8_448>{{Ref PCPBoD8|448}}</ref>
*Scoleces - knoblike anterior end of a tapeworm.<ref>[http://www.thefreedictionary.com/scoleces http://www.thefreedictionary.com/scoleces]. Accessed on: 10 January 2010.</ref>
*Organisms:
**Hooklets.
**Scoleces - knoblike anterior end of a tapeworm.<ref>[http://www.thefreedictionary.com/scoleces http://www.thefreedictionary.com/scoleces]. Accessed on: 10 January 2010.</ref>


==Enterobius vermicularis==
==Enterobius vermicularis==
*AKA ''pinworm''.
*AKA ''pinworm''.
===General===
*Classically found in a [[vermiform appendix]] removed for appendicitis that does not have [[acute appendicitis]].<ref name=pmid7945067>{{Cite journal  | last1 = Dahlstrom | first1 = JE. | last2 = Macarthur | first2 = EB. | title = Enterobius vermicularis: a possible cause of symptoms resembling appendicitis. | journal = Aust N Z J Surg | volume = 64 | issue = 10 | pages = 692-4 | month = Oct | year = 1994 | doi =  | PMID = 7945067 }}</ref>
**See: ''[[Vermiform appendix#Enterobius vermicularis]]''.


Features:<ref>APBR P.685.</ref>
===Gross===
*Ovoid eggs - double walled shells, one side flat.
*Peri-anal white squiggly thing ~ 2-13 mm in length.


Image:
*[http://www.dijitalimaj.com/alamyDetail.aspx?img={14157DA6-DBE8-4E03-BE4A-69591588E153} Pinworm (dijitalimaj.com)].


==Viruses==
===Microscopic===
Many virus afflicit humans. Only a few of them can be diagnosed histologically.
Features - organism:
*0.2-0.5 mm width x 2-13 mm length.
*Characteristic triangular "spikes" seen on cross section - base x height ~ 30 x 30 μm.
**''Spikes'' is in quotations, as these are really a longitudinal blade-like ridges, that run the length of the worm.  


==Viral inclusions==
Features - eggs:<ref name=Ref_APBR685>{{Ref APBR|685}}</ref>  
Cowdry types:<ref>URL: [http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970864-6&figureId=fig3&ecomponentId=mmc3 http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970864-6&figureId=fig3&ecomponentId=mmc3]. Accessed: 12 January 2010.</ref>
*Ovoid - double walled shells, one side flat.
*Cowdry type A inclusion:<ref>URL: [http://www.whonamedit.com/synd.cfm/3495.html http://www.whonamedit.com/synd.cfm/3495.html]. Accessed on: 22 January 2010.</ref>
**Round eosinophilic material surrounded by a clear halo.
*Cowdry type B inclusion:<ref>[http://www.whonamedit.com/synd.cfm/3496.html http://www.whonamedit.com/synd.cfm/3496.html]. Accessed on: 22 January 2010.</ref>
**Neuropathology thingy. (???)


Images:
====Images====
*[http://www.daff.gov.au/animal-plant-health/pests-diseases-weeds/aquatic_animal_diseases_significant_to_australia_identification_field_guide/diseases_of_crustaceans/viral_diseases_of_crustaceans/infectious_hypodermal_and_haematopoietic_necrosis/histological_page_for_infectious_hypodermal_and_haematopoietic_necrosis Cowdry A inclusion (daff.gov.au)].
www:
*[http://focosi.altervista.org/pathohomoprocess_regressive.html Cowdry type A & type B inclusions (altervista.org)].
*[http://www.brown.edu/Courses/Digital_Path/systemic_path/GI/enterobius.html Enterobius (brown.edu)].
<gallery>
Image:Enterobius_-_very_low_mag.jpg | Enterobius - very low mag. (WC)
Image:Enterobius_-_high_mag.jpg | Enterobius - high mag. (WC)
Image:Pinworms_in_the_Appendix_%281%29.jpg | Pinworm (WC)
</gallery>
==Trichinella==
===General===
*Causes ''Trichinosis''.
**Classically associated with uncooked pork.<ref name=pmid17072975>{{cite journal |author=Kaewpitoon N, Kaewpitoon SJ, Philasri C, ''et al.'' |title=Trichinosis: epidemiology in Thailand |journal=World J. Gastroenterol. |volume=12 |issue=40 |pages=6440–5 |year=2006 |month=October |pmid=17072975 |doi= |url=http://www.wjgnet.com/1007-9327/12/6440.asp}}</ref>
*Several types; most due to ''T. spiralis''.<ref name=pmid17072975/>
 
===Microscopic===
Features:
*Worm.
 
Image:
*[http://www.microbiologybytes.com/introduction/Paraquiz/QUIZ06A.html Muscle bx with trichinella (microbiologybytes.com)].
*[http://library.med.utah.edu/WebPath/jpeg2/MUSC010.jpg Trichinella (med.utah.edu)].<ref>URL: [http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html]. Accessed on: 5 December 2010.</ref>


==Herpes simplex virus (HSV)==
==Cysticercosis==
*Canker sores - usually HSV-1.
===General===
*Genital herpes - usually HSV-2.
*Caused by ''Taenia solium''; pork tapeworm.
*May cause [[epilepsy]]; most common parasitic CNS infection.<ref name=pmid19208982>{{cite journal |author=Prasad KN, Prasad A, Verma A, Singh AK |title=Human cysticercosis and Indian scenario: a review |journal=J. Biosci. |volume=33 |issue=4 |pages=571–82 |year=2008 |month=November |pmid=19208982 |doi= |url=}}</ref>


===Histology/cytology===
===Gross===
Features:<ref>SM. 11 January 2010.</ref>
*Multiple cystic spaces.
*Clear "ground glass" nuclei.
**Rim of peripheral chromatin.
*Nuclear inclusions.
*Multinucleation with nuclear molding, i.e. multiple nuclei that touch over a large surface area.


Image:
Image:
*[http://www.virology.org/sbpgphoto2.html Herpes simplex virus - multinucleation (virology.org)]
*[http://reference.medscape.com/features/slideshow/neurocysticercosis Neurocysticercosis (medscape.com)].


==Cytomegalovirus (CMV)==
===Microscopic===
Features:
Features:
*Very large nucleus (as the name implies) with clearing.
*Large ovoid body with complex structures (cross-section of worm) - size: millimetres.
*Granular cytoplasmic inclusions (red on H&E sections).
**+/-External eosinophilic microvilli.
**+/-Gastrointestinal tract - ovoid structure within the worm.
 
Notes:
*Histomorphology is not distinctive for the type... microbiology usually figures it out.


Images:
Images:
*[http://commons.wikimedia.org/wiki/File:CMV_placentitis2_mini.jpg CMV placentitis (WC)].
*[http://www.dpd.cdc.gov/dpdx/html/imagelibrary/A-F/Cysticercosis/body_Cysticercosis_il1.htm Cysticercosis (cdc.gov)].
*[http://www.sciencephoto.com/media/116340/enlarge Cysticercosis (sciencephoto.com)].
*[http://path.upmc.edu/cases/case154.html Neurocysticercosis - case 1 (upmc.edu)].
*[http://path.upmc.edu/cases/case376.html Neurocysticercosis - case 2 (upmc.edu)].
 
==Rhinosporidiosis==
:'''''Not''' to be confused with [[rhinoscleroma]]''.
===General===
*Caused by parasite ''Rinosporidium seeberi''.
**India, Sri Lanka.
*Nasal mass.
**May present with obstruction.<ref name=pmid16945122/>
 
===Microscopic===
Features:<ref>URL: [http://www.histopathology-india.net/Rhino.htm http://www.histopathology-india.net/Rhino.htm]. Accessed on: 4 January 2012.</ref><ref name=pmid16945122/>
*Globular cysts ~ 100 micrometers with endospores:
**Hyperchromatic (blue) spherical 10-100 micrometer.
 
Images:
*[http://www.arquivosdeorl.org.br/conteudo/imagesFORL/11-02-19-fig01-ing.gif Rhinosporidiosis (arquivosdeorl.org.br)].<ref>URL: [http://www.arquivosdeorl.org.br/conteudo/acervo_eng.asp?id=428 http://www.arquivosdeorl.org.br/conteudo/acervo_eng.asp?id=428]. 4 January 2012.</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560165/figure/F1/ Rhinosporidiosis (nih.gov)].<ref name=pmid16945122>{{Cite journal  | last1 = Morelli | first1 = L. | last2 = Polce | first2 = M. | last3 = Piscioli | first3 = F. | last4 = Del Nonno | first4 = F. | last5 = Covello | first5 = R. | last6 = Brenna | first6 = A. | last7 = Cione | first7 = A. | last8 = Licci | first8 = S. | title = Human nasal rhinosporidiosis: an Italian case report. | journal = Diagn Pathol | volume = 1 | issue =  | pages = 25 | month =  | year = 2006 | doi = 10.1186/1746-1596-1-25 | PMID = 16945122 |PMC = 1560165 | URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560165/?tool=pubmed}}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560165/figure/F2/ Rhinosporidiosis (nih.gov)].
 
===Stains===
*[[GMS stain]] +ve organisms.
 
==Leishmaniasis==
===General===
*Caused by protozoa in the group ''Leishmania'' group.
*Transmitted to humans by the ''sand fly''.
 
May be:
*Cutaneous.<ref name=pmid20377337>{{Cite journal  | last1 = Goto | first1 = H. | last2 = Lindoso | first2 = JA. | title = Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. | journal = Expert Rev Anti Infect Ther | volume = 8 | issue = 4 | pages = 419-33 | month = Apr | year = 2010 | doi = 10.1586/eri.10.19 | PMID = 20377337 }}</ref>
*Mucocutaneous.<ref name=pmid20377337/>
*Visceral.<ref name=pmid19708817>{{Cite journal  | last1 = den Boer | first1 = ML. | last2 = Alvar | first2 = J. | last3 = Davidson | first3 = RN. | last4 = Ritmeijer | first4 = K. | last5 = Balasegaram | first5 = M. | title = Developments in the treatment of visceral leishmaniasis. | journal = Expert Opin Emerg Drugs | volume = 14 | issue = 3 | pages = 395-410 | month = Sep | year = 2009 | doi = 10.1517/14728210903153862 | PMID = 19708817 }}</ref>
 
===Microscopic===
Features:
*Small ~1-2 micrometers.
 
====Images====
<gallery>
Image:Leishmania_donovani_01.png | Leishmania - smear. (WC)
Image:Leishmania_2009-04-14_smear.JPG | Leishmania - bone marrow. (WC)
Image:Cutaneous_Leishmaniasis_x100 | Leishmania - cutaneous. (WC)
</gallery>
www:
*[http://www.cdc.gov/parasites/leishmaniasis/index.html Leishmania and sand fly (cdc.gov)].
 
===Stains===
*[[Giemsa stain]] - highlights organisms.
 
=Viruses=
{{Main|Viruses}}
This is a fairly big topic.  There are about half a dozen viral inclusions (e.g. [[CMV]], [[HSV]], [[VZV]], [[adenovirus]]) a decent pathologist ought to be able to identify.  The ''virus'' article covers 'em.
 
=Bacteria=
{{Main|Bacteria}}
This is a small topic when considered from the perspective of an anatomical pathologist.  Most stuff is sorted-out by microbiology.
 
=Protozoa=
A historical category of organisms. Lifeforms previously categorized as ''protozoa'' are in several different ''kingdoms''.
{{Main|Amebiasis}}
{{Main|Leishmaniasis}}
{{Main|Pneumocystis jirovecii}}
{{Main|Toxoplasma}}
 
=Microorganisms and cancer=
==Viruses and cancer==
A number of microorganisms are associated with the development of cancer:<ref>{{Ref PCPBoD8|168}}</ref>
*[[Human papillomavirus]] (HPV) - cancer of cervix, vulva, vagina, penis, anus, head & neck.
*[[Epstein-Barr virus]] - [[Burkitt lymphoma]], [[Post-transplant lymphoproliferative disorder]], classical [[Hodgkin lymphoma]] (all but ''[[Nodular sclerosis Hodgkin lymphoma|nodular sclerosis HL]]''), [[nasopharyngeal carcinoma]].
*[[Hepatitis B]] - [[HCC]].
*[[Hepatitis C]] - [[HCC]].
*[[Lymphoma#Adult_T-cell_leukemia.2Flymphoma|Human T-cell lymphotropic virus type I]] (HTLV-1) - [[Adult T-cell leukemia/lymphoma]].
*[[Human herpesvirus-8]] (HHV-8) - [[Kaposi sarcoma]], [[primary effusion lymphoma]], body cavity lymphoma.
*[[Merkel cell carcinoma|Merkel cell polyomavirus]] - [[Merkel cell carcinoma]].
 
==Bacteria and cancer==
*[[Helicobacter pylori]] - [[MALT lymphoma]], [[gastric carcinoma]].
 
==Parasites and cancer==
*[[Schistosoma haematobium]] - [[squamous cell carcinoma of the urinary bladder]].
*Clonorchis sinensis (AKA Opisthorchis sinensis) - [[cholangiocarcinoma]].
*Opisthorchis viverrini - [[cholangiocarcinoma]].


==See also==
=See also=
*[[Staining]]
*[[Staining]].
*[[Immunohistochemistry]]
*[[Immunohistochemistry]].
*[[Viruses]].


==References==
=References=
{{reflist|2}}
{{reflist|2}}


=External links=
*[http://www.fujita-hu.ac.jp/~tsutsumi/index.html Pathology of Infectious Diseases (fujita-hu.ac.jp)].


[[Category:Basics]]
[[Category:Basics]]
[[Category:Microorganisms]]

Latest revision as of 15:43, 4 December 2023

Microorganisms show-up every once in a while. It is essential to know 'em.

Microorganisms

Fungi

Name (disease) Kingdom Size Shape Stains Other (microscopic) Clinical References Image
Aspergillus (aspergillosis) Fungi ? Hyphae that branching
with 45 degrees angle
PAS-D Fruiting heads when aerobic ? Immunosuppression [1]
Aspergillus. (WC)
Zygomycota (zygomycosis);
more specific
Mucorales (mucormycosis)
Fungi ? Branching hyphae with variable width ? Granulomata assoc. Diabetes, immunodeficient [1]
Zygomycosis. (WC)
Coccidioides, usually C. immitis
(coccidioidomycosis)
Fungi Large - 20-60 micrometers,
endospores 1-5 micrometers
Spherules Stains? Other? Immunodeficient [1] Coccidioidomycosis (med.sc.edu)
C. immitis (WC)
Histoplasma (histoplasmosis) Fungi 2-5 micrometers Spherical GMS Intracellular (unlike candida), granulomata Source: soil with bird droppings [1]
Histoplasmosis. (WC)
Blastomyces (blastomycosis) Fungi 5-15 micrometres Spherical (yeast) Stains? Granulomas, broad-based budding yeast Habitat: Northeast America, Africa [1][2]
Blastomyces. (WC)
Paracoccidioides (paracoccidioidomycosis) Fungi 6-60 micrometres Spherical (yeast) Stains? Multiple budding "steering wheel" appearance Clinical??? [1]
P. brasiliensis (WC)
Pneumocystis jirovecii (pneumocystis carinii pneumonia; abbrev. PCP) Fungi (previously thought to be a protozoan) 7-8 micrometres "Dented ping-pong ball" GMS Usually in clusters of alveolar casts with a honeycomb appearance HIV/AIDS associated [3]
PCP. (WC)
Cryptococcus (cryptococcosis) Fungi 5-15 micrometres Yeast GMS Prominent (i.e. thick polysaccharide) capsule HIV/AIDS associated, most common CNS fungus [1]
Crytococcosis - mucicarmine (WC)

Notes:

  • Bold text = key features.

Fungi

  • There are lots of 'em. Below are a few of 'em.

Terminology:[4]

  • Hyphae = microscopic filamentous growth (of fungi) -- single cell.
  • Mycelial = filamentous network of hyphae.
  • Septae/septation = hyphae may be subdivided by septae -- if they aren't they are one mass of protoplasm. (?)
  • Dimorphism = exist in two forms; e.g. single cell (yeast) and mycelial growth.
  • Pseudohyphae = looks like hyphae --but branching pattern is created by separate cells.[5]

Tissue invasive fungi

Typically:[6]

  • Mucor.
  • Aspergillus.

List

Worms & stuff

Schistosomiasis

See Urine cytopathology.

General

  • Trematode, i.e. type of worm.

Microscopic

Features of ova (S. haematobium):[7]

  • Elliptical ~140 micrometres max dimension.
  • "Spike" approx. the size of a PMN.

Images

www:

Toxoplasma

General

  • Common CNS infection.
    • Toxoplasma gondii - pathogenic; causes toxoplasmosis.
  • Previously classified as a protozoa.
  • A TORCH infection.

Microscopic

General:

  • Tachyzoites (Invasive form):
    • Crescent-shaped organisms that are 2-3μm wide by 4-8μm long.
  • Bradyzoites:
    • Are founded within the tissue cysts and are shorter than tachyzoites.
  • Oocysst:
    • Ovoid shape that measures 10μm to 12μm and contains four sporozoites.
  • Histopathological features depend on location in body.

Lymph node

LN features:[8]

  • Reactive germinal centers (pale areas - larger than usual).
    • Often poorly demarcated - due to loose epithelioid cell clusters at germinal center edge - key feature.
  • Epithelioid cells - perifollicular & intrafollicular.
    • Loose aggregates of histiocytes (do not form round granulomas):
      • Abundant pale cytoplasm.
      • Nucleoli.
  • Monocytoid cells (monocyte-like cells) - in cortex & paracortex.
    • Large cells in islands/sheets key feature with:
      • Abundant pale cytoplasm - important.
      • Well-defined cell border - important.
      • Singular nucleus.
    • Cell clusters usually have interspersed neutrophils.

Images (lymph node):

CNS

CNS features:[9]

  • Granular appearing ball ~ 2x the size of resting lymphocyte.
Images (CNS)

www:

Heart

Features:

  • Intramuscular organisms.

DDx:

Images (heart):

IHC

  • IHC for toxoplasma.[10]

Strongyloidiasis

General

  • Causes by worm Strongyloides stercoralis.
  • High case mortality rate ~ 70%.[11]
  • May present after years of latency due to immune suppression.[12]

Location:

  • Lung. (???)

Microscopic

Features:

  • Long worms.
  • ~10-15 micrometers wide.

Images

www:

Echinococcus

Microscopic

Features:

  • Laminated wall +/- calcification.[13]
  • Organisms:
    • Hooklets.
    • Scoleces - knoblike anterior end of a tapeworm.[14]

Enterobius vermicularis

  • AKA pinworm.

General

Gross

  • Peri-anal white squiggly thing ~ 2-13 mm in length.

Image:

Microscopic

Features - organism:

  • 0.2-0.5 mm width x 2-13 mm length.
  • Characteristic triangular "spikes" seen on cross section - base x height ~ 30 x 30 μm.
    • Spikes is in quotations, as these are really a longitudinal blade-like ridges, that run the length of the worm.

Features - eggs:[16]

  • Ovoid - double walled shells, one side flat.

Images

www:

Trichinella

General

  • Causes Trichinosis.
    • Classically associated with uncooked pork.[17]
  • Several types; most due to T. spiralis.[17]

Microscopic

Features:

  • Worm.

Image:

Cysticercosis

General

  • Caused by Taenia solium; pork tapeworm.
  • May cause epilepsy; most common parasitic CNS infection.[19]

Gross

  • Multiple cystic spaces.

Image:

Microscopic

Features:

  • Large ovoid body with complex structures (cross-section of worm) - size: millimetres.
    • +/-External eosinophilic microvilli.
    • +/-Gastrointestinal tract - ovoid structure within the worm.

Notes:

  • Histomorphology is not distinctive for the type... microbiology usually figures it out.

Images:

Rhinosporidiosis

Not to be confused with rhinoscleroma.

General

  • Caused by parasite Rinosporidium seeberi.
    • India, Sri Lanka.
  • Nasal mass.
    • May present with obstruction.[20]

Microscopic

Features:[21][20]

  • Globular cysts ~ 100 micrometers with endospores:
    • Hyperchromatic (blue) spherical 10-100 micrometer.

Images:

Stains

Leishmaniasis

General

  • Caused by protozoa in the group Leishmania group.
  • Transmitted to humans by the sand fly.

May be:

Microscopic

Features:

  • Small ~1-2 micrometers.

Images

www:

Stains

Viruses

This is a fairly big topic. There are about half a dozen viral inclusions (e.g. CMV, HSV, VZV, adenovirus) a decent pathologist ought to be able to identify. The virus article covers 'em.

Bacteria

This is a small topic when considered from the perspective of an anatomical pathologist. Most stuff is sorted-out by microbiology.

Protozoa

A historical category of organisms. Lifeforms previously categorized as protozoa are in several different kingdoms.

Microorganisms and cancer

Viruses and cancer

A number of microorganisms are associated with the development of cancer:[25]

Bacteria and cancer

Parasites and cancer

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 682. ISBN 978-1416025887.
  2. http://pathmicro.med.sc.edu/mycology/mycology-6.htm
  3. Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 684. ISBN 978-1416025887.
  4. http://www.fungionline.org.uk/1intro/3growth_forms.html
  5. http://pathmicro.med.sc.edu/mycology/mycology-3.htm
  6. CM 17 Apr 2009.
  7. URL: http://path.upmc.edu/cases/case622/dx.html. Accessed on: 26 January 2012.
  8. Ioachim, Harry L; Medeiros, L. Jeffrey (2008). Ioachim's Lymph Node Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 113. ISBN 978-0781775960.
  9. URL: http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm. Accessed on: 19 October 2010.
  10. URL: http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0I001-PQ01-M.htm. Accessed on: 19 October 2010.
  11. Lim, S.; Katz, K.; Krajden, S.; Fuksa, M.; Keystone, JS.; Kain, KC. (Aug 2004). "Complicated and fatal Strongyloides infection in Canadians: risk factors, diagnosis and management.". CMAJ 171 (5): 479-84. doi:10.1503/cmaj.1031698. PMID 15337730.
  12. Siddiqui, AA.; Berk, SL. (Oct 2001). "Diagnosis of Strongyloides stercoralis infection.". Clin Infect Dis 33 (7): 1040-7. doi:10.1086/322707. PMID 11528578.
  13. Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 448. ISBN 978-1416054542.
  14. http://www.thefreedictionary.com/scoleces. Accessed on: 10 January 2010.
  15. Dahlstrom, JE.; Macarthur, EB. (Oct 1994). "Enterobius vermicularis: a possible cause of symptoms resembling appendicitis.". Aust N Z J Surg 64 (10): 692-4. PMID 7945067.
  16. Lefkowitch, Jay H. (2006). Anatomic Pathology Board Review (1st ed.). Saunders. pp. 685. ISBN 978-1416025887.
  17. 17.0 17.1 Kaewpitoon N, Kaewpitoon SJ, Philasri C, et al. (October 2006). "Trichinosis: epidemiology in Thailand". World J. Gastroenterol. 12 (40): 6440–5. PMID 17072975. http://www.wjgnet.com/1007-9327/12/6440.asp.
  18. URL: http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html. Accessed on: 5 December 2010.
  19. Prasad KN, Prasad A, Verma A, Singh AK (November 2008). "Human cysticercosis and Indian scenario: a review". J. Biosci. 33 (4): 571–82. PMID 19208982.
  20. 20.0 20.1 20.2 Morelli, L.; Polce, M.; Piscioli, F.; Del Nonno, F.; Covello, R.; Brenna, A.; Cione, A.; Licci, S. (2006). "Human nasal rhinosporidiosis: an Italian case report.". Diagn Pathol 1: 25. doi:10.1186/1746-1596-1-25. PMC 1560165. PMID 16945122. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1560165/.
  21. URL: http://www.histopathology-india.net/Rhino.htm. Accessed on: 4 January 2012.
  22. URL: http://www.arquivosdeorl.org.br/conteudo/acervo_eng.asp?id=428. 4 January 2012.
  23. 23.0 23.1 Goto, H.; Lindoso, JA. (Apr 2010). "Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis.". Expert Rev Anti Infect Ther 8 (4): 419-33. doi:10.1586/eri.10.19. PMID 20377337.
  24. den Boer, ML.; Alvar, J.; Davidson, RN.; Ritmeijer, K.; Balasegaram, M. (Sep 2009). "Developments in the treatment of visceral leishmaniasis.". Expert Opin Emerg Drugs 14 (3): 395-410. doi:10.1517/14728210903153862. PMID 19708817.
  25. Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 168. ISBN 978-1416054542.

External links