The document discusses 5 case studies:
1. A duodenal biopsy showing Giardia lamblia infection
2. An ileal biopsy showing Entamoeba histolytica infection
3. A subcutaneous nodule biopsy showing cysticercosis
4. A splenic mass biopsy showing an Echinococcus granulosus (hydatid cyst)
5. A lung mass showing fungal infection suggestive of pulmonary cryptococcosis
For each case, the summary provides key microscopic findings, impressions, and differentiating points about the infectious organisms observed. Differential diagnoses and descriptions of the pathogens are also discussed.
Balantidium coli.pptx medical parasitologyosmanolow
Medical parasitology traditionally has included the study of three major groups of animals: parasitic protozoa, parasitic helminths (worms), and those arthropods that directly cause disease or act as vectors of various pathogens. A parasite is a pathogen that simultaneously injures and derives sustenance from its host
Balantidium coli.pptx medical parasitologyosmanolow
Medical parasitology traditionally has included the study of three major groups of animals: parasitic protozoa, parasitic helminths (worms), and those arthropods that directly cause disease or act as vectors of various pathogens. A parasite is a pathogen that simultaneously injures and derives sustenance from its host
Entamoeba histolytica. Medical parasitology pptxosmanolow
Medical parasitology traditionally has included the study of three major groups of animals: parasitic protozoa, parasitic helminths (worms), and those arthropods that directly cause disease or act as vectors of various pathogens. A parasite is a pathogen that simultaneously injures and derives sustenance from its hos
Hamster - Bacterial, Viral, Mycotic, Parasitic and Non infectious diseasesRakshith K, DVM
There are approximately 25 different hamster species worldwide.
In labs: Syrian or golden hamster (Mesocricetus auratus) and Chinese or gray hamster (Cricetulus griseus)
Hamsters possess buccal pouches, which extend dorsolaterally from the oral cavity on either side of the shoulder region.
Bacterial diseases: Proliferative ileitis, Clostridial diseases, Tyzzers disease, Salmonellosis, Campylobacter jejuni, Escherichia coli, Yersiniosis, Respiratory disease, Mastitis, Abscess, Mycotic infection, Viral diseases, Parasitic diseases and Non infectious diseases.
Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
EPIDIDYMAL CYST
VARICOCELE
Entamoeba histolytica. Medical parasitology pptxosmanolow
Medical parasitology traditionally has included the study of three major groups of animals: parasitic protozoa, parasitic helminths (worms), and those arthropods that directly cause disease or act as vectors of various pathogens. A parasite is a pathogen that simultaneously injures and derives sustenance from its hos
Hamster - Bacterial, Viral, Mycotic, Parasitic and Non infectious diseasesRakshith K, DVM
There are approximately 25 different hamster species worldwide.
In labs: Syrian or golden hamster (Mesocricetus auratus) and Chinese or gray hamster (Cricetulus griseus)
Hamsters possess buccal pouches, which extend dorsolaterally from the oral cavity on either side of the shoulder region.
Bacterial diseases: Proliferative ileitis, Clostridial diseases, Tyzzers disease, Salmonellosis, Campylobacter jejuni, Escherichia coli, Yersiniosis, Respiratory disease, Mastitis, Abscess, Mycotic infection, Viral diseases, Parasitic diseases and Non infectious diseases.
Disclaimer: A lot from this slides were taken also from https://www.slideshare.net/babysurgeon/scrotal-swellings-1 (Dr Selvaraj Balasubramani)
This covers only :
ANATOMY
CAUSES
TORSION OF TESTIS
EPIDIDYMO-ORCHITIS
HYDROCELE
EPIDIDYMAL CYST
VARICOCELE
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
5. Summary:
• Section from duodenal biopsy shows four tissue bits
lined by simple columnar epithelium with goblet cells
exhibiting maintained crypts to villi ratio. No villi
blunting or increase in IEL noted. Numerous
eosinophilic pear shaped organism with paired nuclei is
noted in between the villi. Lamina propria shows
dense infiltration of chronic inflammatory cells
predominantly comprising plasma cells, lymphocytes
followed by eosinophils. Benign lymphoid follicles with
germinal center noted. Submucosa shows brunner
gland. No dysplasia or evidence of malignancy seen.
• Impression: Duodenal Biopsy;-Suggestive of protozoal
Infection; Giardiasis.
6. Giardiasis
Favouring points
• Numerous eosinophilic pear
shaped organism with
paired nuclei is noted inter
villious space,
• Dense lymphoplasmacytic
infiltrates and eosinophils
noted
Non-favouring points
• No increase in IEL
• No villious blunting
7. Introduction
• Protozoan infection associated with
malabsorption, chronic diarrhea.
• Spreads by fecally contaminated water,
common in underdeveloped countries.
• Affects 1/3 of homosexual men in urban
communities.
8. Introduction
• Attaches to mucosa but does not invade.
• May cause endoscopic duodenal nodularity.
• Causes epithelial barrier dysfunction by down
regulating claudin1 and increasing epithelial
apoptoses .
9. Introduction
• Clinical features -
usually two or more of
the following:
• Diarrhea - x5 days.
• Flatulence.
• Foul smelling feces.
• Nausea.
• Abdominal cramps.
• Excessive tiredness.
Etiology:
• Flagellate
protozoan Giardia
lamblia.
• Treatment
• Antibiotics, e.g.
metronidazole
10.
11. Diagnosis
• Stool: Cysts,
trophozoites or
antigens.
• Positive stains:
– Trichrome with iron
hematoxylin
counterstain
– Giemsa stain
– KIT / CD117 may be
useful for diagnosis
15. Summary
• Section from ileal biopsy shows four tissue bits lined by
simple columnar epithelium with goblet cells
exhibiting areas of ulceration. Crypt architectural
disruption is also noted. Underlying lamina propria
shows glands lined by simple columnar epithelium with
goblet cells along with chronic inflammatory cells
comprising of lymphocytes and few plasma cells.
Within the ulcer bed and exudates are numerous round
to oval shaped organisms are seen extending into the
submucosa. These organisms exhibit abundant
cytoplasm and small round nucleus and are showing
ingested erythrocytes. No dysplasia or evidence of
malignancy seen.
• Impression: Ileum, Biopsy:- Intestinal amebiasis (E.
histolytica)
16. E. histolytica:
Favouring points:
• Inflammatory exudates
• Chronic inflammatory cells
• Round to oval organisms
with abundant cytoplasm
with ingested RBCs.
Unfavouring points:
• Site: Ileum (uncommon site)
17. Differentials:
• Balantidium coli (Balantioides coli):
– Flask shaped ulcers resembling amebiasis
– Large (40 - 200 micrometers) ciliated trophozoites invading the
mucosa and submucosa
• Crohn's disease:
– Active chronic colitis
– No infiltrating trophozoites
• Histiocytes (also known as tissue macrophages):
– Present in various inflammatory and infectious conditions
– Similar size to Entamoeba histolytica trophozoites
– Large, often reniform nucleus (versus small round nucleus of E.
histolytica)
– CD68+
18. Entamoeba histolytica:
• A protozoan parasite
• Causes diarrhea, dysentry and liver abscess in
man
• Habitat: Trophozoites of E. histolytica live in
the mucous and submucous layers of the LI of
man
• Colon:
– Cecum is the most common site.
– Less common in ileum
19. • Transmission:
– ingestion of E. histolytica cysts in fecally contaminated
food or water (fecal - oral)
– sexual contact (oral - anal)
• Associated with:
– fever, abdominal pain, tenesmus, diarrhea (with or
without blood), dysentery
• May disseminate to the liver and other organs
• Flask shaped ulcers; rarely inflammatory mass
(ameboma), perforation
20. • Amebic trophozoites invade the submucosa
• Trophozoites with pseudopod projections, ingested
RBCs in cytoplasm, small round nucleus with dot-like
karyosome and peripheral rim of condensed
chromatin
• Trophozoites: CD68 negative, strongly PAS positive
• Treat:
– Metronidazole or Tinidazole: invasive dzs
– Paromomycin: eradicate luminal cysts
22. Life cycle of E. histolytica
• Mainly 2 phases: Trophozoite and Cystic.
• Infective form: Mature quadrinucleate cyst.
• Transmission: Feco-oral route
Fig: Uninuclate, Binucleate and Mature
quadrinuclate cyst
23.
24. Genesis of hepatic lesions
• Trophozoites are carried as emboli by the
radicles of the portal vein from base of ulcer.
• Capillary system of liver acts as filter and holds
the parasite
• Multiplication occurs
• Local accumulation Obstruction
Thrombosis of portal vein
25.
26. Diagnosis:
• May be suspected based on:
– epidemiologic factors, patient symptoms, radiologic or colonoscopic
findings
• Detected via:
– stool microscopy (ova and parasite examination)
– stool antigen
– stool nucleic acid testing
• Serologic testing : antibodies supports the diagnosis of amebiasis
but cannot differentiate current from past infection
– Most useful for diagnosing disseminated disease
• Cyst aspiration:
– absence of other microorganisms supports evidence of amebic liver
abscess
30. Summary
• Section from subcutaneous nodule shows tissue
composed of lobules of mature adipocytes
separated by thick fibromuscular septa. Within
these lobules lie a cystic cavity devoid of
epithelial lining but comprising of by fibroblasts,
multinucleated giant cells, ill-formed granulomas
and mixed inflammatory infiltrates. Cystic cavity
shows irregularly shaped double layered
eosinophilic membrane with numerous round to
oval spherical basophilic structure within.
Hemosiderin deposit in vacuolated spaces noted
in the membrane.
• Impression: Subcuatneous nodule:- Parasitic
infection suggestive of Cysticercosis
31. Cysticercosis:
Favouring points
• Irregularly shaped double
layered eosinophilic
membrane with numerous
round to oval spherical
basophilic structure
• Predominantly
multinucleated giant cells,
foreign body giant cells,
histocytes and epitheloid
cells.
Non favouring points
• No scolex and hooklet and
sucker noted.
32. Cysticercosis:
• Tissue infection caused by ingestion of larval cysts of the
cestode Taenia solium (cysticercus cellulose)
• Acquired by swallowing food, water or feces contaminated
by T. solium eggs
• In cystecicercosis, the human represents an intermediate
host and the parasite develops cysticerci in various organs
• Taeniasis: infection caused by the adult tapeworm in the
human intestine, which occurs from ingestion of larvae in
undercooked pork
• Cysticerci: larval forms of tapeworms found within a fluid
filled cyst
33. • Sites:
– Nervous system, heart,
skeletal muscle, eyes and
subcutaneous tissue
– Cases in breast are rare
• Etiology:
– Accidental ingestion of
eggs or gravid
proglottids of Taenia
solium by human host
via infected food, water
or feces
• Clinical features:
– Cysticercosis of the skin
is rare
• Palpable subcutaneous
nodule
– Breast: freely mobile
cystic mass
• Radiology description:
– CT scan: hyperdense
lesions in subcutaneous
tissue with or without
calcification
– USG: cystic lesions
34. • Diagnosis:
– History
– Skin biopsy
– Serology (serum or CSF)
– Imaging
• Positive stains
– Hooklets of cysticerci
can be acid fast
• Treatment:
– Praziquantel and
albendazole
– Large, solitary lesions:
Surgery
• Prolonged antiparasitic
therapy
35.
36. Gross Examination
• Circumscribed, white to tan, cystic nodules containing a clear fluid
• Viable cysts are translucent, through which a single scolex may be
visible (2 - 3 mm nodule)
• As the cyst begins to degenerate, the fluid becomes dense and
opaque
• In the later stages, only a calcified nodule may be present
• Cyst sizes vary; commonly 1 mm - 2 cm
• Larval forms identified within the cyst cavity
37.
38. Microscopic Findings:
• Cystic cavity contains the the larval form: scolex with hooklets and 2
pairs of suckers.
• The larval form, composed of duct-like invaginations, is lined by a
double layered, eosinophilic membrane.
• Scolex is single and invaginated; contains a rostellum, 4 suckers and
22 - 23 birefringent hooklets (may persist for a long time)
• Body wall exhibits a myxoid matrix and calcareous bodies (calcified
concretions)
• Cysticerci may remain viable for years
39. Microscopic Findings
Colloidal stage
• First stage of involution of
cysticerci
• Transparent vesicular fluid is
replaced by a turbid,
viscous fluid
• the scolex shows signs of
hyaline degeneration
Granular stage
• cysticercus is no longer
viable
• cyst wall thickens
• Scolex is transformed into
coarse mineralized granules
40. Microscopic Findings
• Host inflammatory reaction is usually not
present if the larva is viable.
• Finally, a granulomatous reaction develops
characterized by histiocytes, epitheloid cells
and foreign body giant cells,
• leading to fibrosis of the supporting stroma
and calcification of the parasitic debris
43. Cytology: Findings
• Fibrillary stroma with interspersed nuclei and
a honeycomb pattern
• Parts of parasite may be identifiable
• Background usually consists of a mixed
inflammatory infiltrate
• Granulomas may be seen
48. Summary:
• Section from splenic mass shows splenic
parenchyma composed of white pulp formed by
lymphatic nodules and the rest is composed of
vascular red pulp. There is a cystic cavity lined by
fibrous tissue with organisms inside that cavity.
The organism has outer acellular laminated
membrane, a germinal membrane and
protoscolices attached to the membrane. These
protoscolices are round to ovoid in shapes and
contain refractile sucker and hooklets.
• Impression: Splenic Biopsy:-Hydatid cyst (E.
granulosus)
49. Introduction
• Tissue invasive parasite
• Class: Cestoda
• Genus: Echinoccus
• Invade major tissues and organs of human
• Humans are accidental host(dead end host)
• Definitive host: Canines; Dog
• Intermediate host: Sheep
52. Clinical features
• Commonly develop liver but may also involve
brain, lung, spleen, breast
• A liver cyst may produce no symptoms until it is
very large
• Pain and discomfort in upper abdominal region
• Nausea and vomiting with increasing size of cyst
or ruptured cyst
• Rupture of pulmonary cyst into bronchus can lead
to severe allergic reactions and coughing up of
blood mixed fluid containing hyadatid cyst tissue
53. Diagnosis
• Usually made on USG or CT scan
• Monoclonal antibodies to hydatid antigen
detection by immunoelectrophoresis, ELISA
and immunoblot
56. Summary:
• Section shows two linear cores comprising of
fibrocollagenous tissue along with areas of
necrosis and hemorrhage. Numerous refractile
round to oval encapsulated organisms having thin
cell wall with budding are seen in
fibrocollagenous tissues as well as in necrotic
areas. Few foci also shows giant cells. Occasional
anthracotic pigments also noted. No atypical cells
or evidence of malignancy seen.
• Impression: Lung mass, Fungal infection
suggestive of Pulmonary cryptococcosis.
57. Favouring Points:
- Pulmonary mass.
- Round to oval encapsulated
yeasts having thin cell walls
with budding.
Non-favouring Points:
58. Differential Diagnosis:
• Unencapsulated strains mimic:
– Blastomyces and Candida species
– Fontana-Masson positivity is helpful
• Corpora amylacea in neural tissue:
– Concentric lamellations are helpful
59. Cryptococcosis:
• C. neoformans(immunocompromised), C. gattii
(immunocompetent).
• Size: 3-8μm in diameter.
• Disease ranges from cutaneous to severe pulmonary and CNS
disease.
• Pulmonary cryptococcosis: important opportunistic
invasive mycosis in immunocompromised patients
– also increasingly seen in immunocompetent patients.
• Main habitat: Debris around pigeon roosts and soil
contaminated with decaying pigeon or chicken droppings.
62. Diagnosis
• Cryptococcal antigen (CrAg):
– Fast and sensitive test.
– Serum and cerebrospinal fluid
– Pulmonary dzs: sera rarely positive in the
absence of disseminated disease.
- Detects capsular polysachharide antigens
63. Laboratory
- Gram stain: Variably sized yeasts with
budding.
- India ink: Highlights organisms (Rarely used in
clinical practice)
- Culture: Sheep blood, chocolate agar and
fungal media. (Sabouraud dextrose agar).
- Rapidly grows within 24 hours at 37 degree
Celsius.
- Creamy , mucoid colonies formed.