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M9480007.TXT
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1994-08-09
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Document 0007
DOCN M9480007
TI Rhodococcus equi pneumonia and pulmonary malakoplakia in acquired
immunodeficiency syndrome. Pathologic features.
DT 9410
AU Kwon KY; Colby TV; Department of Pathology, Keimyung University School
of Medicine,; Taegu, Korea.
SO Arch Pathol Lab Med. 1994 Jul;118(7):744-8. Unique Identifier : AIDSLINE
MED/94296228
AB Pulmonary infection with Rhodococcus equi is rare, and most cases are
seen in immunocompromised patients, particularly those with acquired
immunodeficiency syndrome. We describe the pathologic features in four
cases of culture-positive R equi pneumonia occurring in patients
infected with human immunodeficiency virus. All four patients had a
solitary cavitary pulmonary mass that was resected (n = 3) or had
undergone biopsy (n = 1). Pathologically, all specimens revealed sheets
of histiocytes with abundant foamy to eosinophilic cytoplasm with
numerous phagolysosomes that were positive for periodic acid-Schiff,
Gomori methenamine silver, and Grocott stains. Occasional histiocytes
contained Michaelis-Gutmann bodies, diagnostic of malakoplakia. The
Michaelis-Gutmann bodies yielded positive results with periodic
acid-Schiff, Gomori methenamine silver, Grocott, Giemsa, and von Kossa
stains (three of three cases studied) and with alizarin red and Prussian
blue stains (two of three cases studied). Many gram-positive
coccobacilli within histiocytes and associated with neutrophils were
found in one case. Ultrastructural study of one case showed histiocytes
containing abundant phagolysosomes with degenerated bacterial components
and Michaelis-Gutmann bodies. The latter had a targetoid appearance with
variegated phagolysosome cores that were mineralized by deposition of
electron-dense spicules surrounded by peripheral rings of granular and
membranous material. Based on our observations and reports in the
literature, there appears to be a more than coincidental association
between pulmonary R equi infection, malakoplakia, and human
immunodeficiency virus infection.
DE Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY
Actinomycetales Infections/*ETIOLOGY/PATHOLOGY Adult Case Report
Human Lung/MICROBIOLOGY/PATHOLOGY Lung Diseases/*ETIOLOGY
Malacoplakia/*ETIOLOGY Male Middle Age Pneumonia/*ETIOLOGY/PATHOLOGY
Rhodococcus equi/*ISOLATION & PURIF Stains and Staining JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).