During my residency in internal medicine some 30 years ago, I was strongly drawn to the clinical practice of infectious disease. My teachers at the University of Pennsylvania were astute clinicians, formidably knowledgeable, and keen observers. During my subsequent training in anatomic pathology at the Massachusetts General Hospital, I considered a career in infectious disease pathology but was hard-pressed to identify it as a viable independent specialty. As a result, I compromised and devoted the next years of my training to specialty interests in both pulmonary medicine and lung pathology, in part because I was aware that many infections affect the lungs.
My subsequent training included research in cellular immunology, and I learned that the primary principles of host defense had largely evolved in response and in parallel to the challenges of infection. Relatively late in my career, I volunteered for the job of being a dedicated expert in infectious disease pathology, and as there was no competition, I got it. In many respects it has proved to be the most rewarding role of my career.
Most surgical pathology departments today are primarily focused on the field of neoplasia; infection has largely become the domain of the microbiology laboratory. Yet the amount of infectious disease pathology that is seen regularly in the practice of surgical pathology in most hospitals is substantial, varied, and diagnostically challenging. In a single week, I often see tens of cases of infection, some of them common, others extraordinary and exotic. It is my considered opinion that the challenges of expert infectious disease pathology diagnosis rival and frequently exceed those of diagnostic tumor pathology.
The nuances of the specialty are unique. They include a degree of clinical expertise, the knowledge of how diseases are geographically distributed, experience in identifying the varied morphological features of a host of pathogens, awareness of how in-host responses vary with levels of immunosuppression, and recognizing when one is not dealing with infection in responses that can mimic it. While most surgical pathologists manage to do a very reasonable job in diagnosing infection, most would admit that their level of sophistication in this area is too frequently limited.
Whereas most textbooks on the topic of infectious disease pathology emphasize details of microbial identification, it is evident that the practicing surgical pathologist primarily needs a firm grounding in recognizing the spectrum of histological responses by the host that can be seen in infection. In a hospital such as my own where pathologists are sub-specialized, surgical pathologists become well versed in how to diagnose the infections that frequently present in their organ of specialized interest. This is unfortunate for those of us who choose to practice infectious disease pathology as a primary subspecialty, as many interesting cases never reach my microscope. But this is easily remedied by maintaining a working relationship with the hospital clinical infectious disease specialists, who invariably make me aware of the cases of interest!
Frankly, few busy pathologists have the time or the inclination to specialize in infection, yet it is just this group that needs access to a single handy resource that will help them to establish an accurate diagnosis. That was the rationale for the present text. As I have noted elsewhere, this text may not invariably provide the level of detail that may be gleaned in the in-depth study of infectious disease morphology. For example, exhaustive detail has not been included with respect to the diagnosis of rare parasitic disorders, but there are already excellent textbooks available that can address these features. This is also not a source book on the molecular aspects of infection; this too can be found elsewhere. What the reader will find here, hopefully, is a practical, accessible, and well illustrated text of the surgical pathology of infection.
-- Author --
Key Features
- 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.
Website Features
- Consult the book from any computer at home, in your office, or at any practice location.
- Instantly locate the answers to your clinical questions via a simple search query.
- Quickly find out more about any bibliographical citation by linking to its MEDLINE abstract.
- Images: Browse a Library of all book images. Easily select, organize, and download your images into a presentation.
Contents
CHAPTER 1 - Introduction
CHAPTER 2 - General Principles in the Diagnosis of Infection
- Introduction
- Sampling
- Diagnosing Infection In Situ
- Potential Limits of Biopsy Interpretation
- Classification of Patterns of Infection
- Histochemical Stains
- Immunohistochemical Methods
- Molecular Diagnostics
- In Situ Hybridization
- REFERENCES
CHAPTER 3 - The Biopsy in the Diagnosis of Infection: Clinical Approach
- Overview: The Biopsy
- Approach to the Patient: General Concepts
- Antimicrobial Therapy
- Biopsy in the Immunocompromised Host
- Timeline of Infection
- Summary
CHAPTER 4 - Cytopathology of Infectious and Inflammatory Diseases
- Introduction
- Processing of Cytologic Samples for Infectious and Inflammatory Diseases
- Culturing of Fine-Needle Aspirations for Microorganisms
- Inflammatory Patterns and Associated Pathogens
- Unusual Host Reactions to Infections in the Immunocompromised Patient
- Cytodiagnosis of Viral Infections
- Case 17: Intensive Care Unit Vocal Cord Lesion
- Case 18: Is It Herpes or Molluscum?
- Case 19: To Immunosuppress or Immunoenhance; That Is the Question!
- Parasitic Disease in Cytology
- Case 20: A Worm with the Wanderlust
- Cases 21 and 22: Parasite Infections Seen in Postmortem Cytology
- Conclusion
CHAPTER 5 - Ultrastructural Diagnosis of Infection
- Introduction
- Electron Microscopy Technique
- Prions
- Viral Infections
- Bacterial Infections
- Fungal Infections
- Parasitic Infections
CHAPTER 6 - Ear, Nose, and Throat Infections
- Bacterial Rhinosinusitis
- Otitis Media
- Tonsillitis
- Peritonsillar Abscess
- Rhinoscleroma
- Actinomycosis
- Botryomycosis
- Syphilis
- Tuberculosis
- Leprosy
- Oral Candidosis
- Fungal Rhinosinusitis
- Paracoccidioidomycosis
- Sporotrichosis
- Blastomycosis
- Coccidioidomycosis
- Cryptococcosis
- Histoplasmosis
- Rhinosporidiosis
- Mucocutaneous Leishmaniasis
- Epstein-Barr Virus
- Herpes Simplex Virus
- Human Papillomavirus
- Human Immunodeficiency Virus
- Mumps
CHAPTER 7 - Pulmonary Infections
- Introduction
- Handling Lung Biopsy Specimens
- Pulmonary Injury in Infection
- Microbes Associated with Bioterrorism
- Pleural Infections
CHAPTER 8 - Cardiac Infections
- Introduction
- The Pathology of Infective Endocarditis
- The Pathology of Myocarditis
- The Pathology of Pericarditis
CHAPTER 9 - Infections of the Gastrointestinal Tract
- Introduction
- Infections of the Esophagus
- Infections of the Stomach
- Infections of the Small Bowel
- Infectious Colitis
CHAPTER 10 - Liver and Bile Duct Infections
- Viruses
- Mycobacteria
- Nonmycobacterial Bacteria
- Spirochetes
- Rickettsia
- Fungi
- Helminths
- Protozoans
CHAPTER 11 - Infectious Lymphadenitis
- Lymphadenitis of Viral or Possible Viral Etiology
- Bacterial Lymphadenitis
- Fungal Lymphadenitis
- Protozoal Lymphadenitis
CHAPTER 12 - Infectious Diseases of the Bone Marrow and Spleen
- Introduction
- Patterns of Bone Marrow Response to Infections
- Bone Marrow Features of Specific Infections
- Infections Involving the Spleen
CHAPTER 13 - Bone Infections
- Pathophysiology
- Bacterial Osteomyelitis
- Mycobacterial Osteomyelitis
- Treponemal Osteomyelitis
- Fungal Osteomyelitis
- Mycetoma
- Helminthic Osteomyelitis
- Viral Osteomyelitis
- Differential Diagnosis of Osteomyelitis
CHAPTER 14 - Infections of Joints, Synovium-Lined Structures, and Soft Tissue
- Bacterial Arthritis
- Fungal Arthritis
- Viral Arthritis
- Reactive Arthritis
- Soft Tissue Infections
- Myositis
- Other Unusual Soft Tissue Infections
CHAPTER 15 - Genitourinary Infectious Disease Pathology
- Genitourinary Cutaneous Infections
- Kidney Infections
- Bladder Infections
- Infections of the Urethra
- Infections of the Male Genitourinary System
CHAPTER 16 - Gynecologic Infections
- Lower Genital Tract
- Upper Genital Tract
CHAPTER 17 - Perinatal Infections
- Ascending Infections
- Hematogenously Spread Infections
- Specific Infectious Organisms
- Pregnancy-Associated Uterine Infections
- Fetal and Congenital Infections
CHAPTER 18 - Infections of the Nervous System
- Introduction
- Acute Inflammatory Response
- Chronic Inflammatory Response
- Granulomatous or Predominantly Histiocytic Inflammatory Pattern
- Minimal or No Inflammatory Response
CHAPTER 19 - Skin Infections
- Diagnostic Approach
- Bacterial Infections of the Skin
- Viral Infections of the Skin
- Fungal Skin Infections
- Protozoal Infections
- Helminth Infestations
- Arthropod-Induced Diseases
- Algal Infections
About the Author
- Richard L. Kradin, MD Associate Professor of Pathology and Medicine, Department of Pathology, Harvard Medical School; Associate Professor of Pathology, Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts.
Product Details
- Hardcover: 660 pages
- Publisher: Saunders; Har/Psc edition (2011)
- Language: English
- ISBN-10: 1416034293
- ISBN-13: 978-1416034292
- Product Dimensions: 11.1 x 8.5 x 1.2 inches
List Price: $218.00