Infectious Diseases-Pictures

Question 1

Answer 1

Cirrhosis of the liver. You can see the round islands of relatively normal liver tissue, surrounded by bands of fibrosis (scarring).

Question 2

Answer 2

Although CMV is the one classically associated with owls eye inclusions, occasionally you will hear people use the term owls eye to refer to the Cowdry Type A (Herpes Simplex) inclusions in herpes simplex, which is what is being pointed to by the arrowhead. The smaller arrow is pointing to the other type of herpes inclusion that has been referred to as ground glass nuclei.

Question 3

Answer 3

Hairy Leukoplakia. AIDS. EBV infection

Question 4

Answer 4

Hairy Leukoplakia.

Question 5

Answer 5

Here’s more ground glass nuclei, so it’s referring to the semi-opaque nature of the nucleus.

Herpes is something you will definitely encounter in oral pathology, since the usual sites of infection are either oral cavity or genitals.

The esophagus is also a relatively common site of infection, especially in immune compromised patients.

HERPES

Question 6

Answer 6

Herpes.

Question 7

Answer 7

Herpes.

Question 8

Answer 8

Herpes. Multinucleation.

Question 9

Answer 9

Karposi’s Sarcoma. HHV-8. Malignancy of blood vessels.

Question 10

Answer 10

Karposi’s Sarcoma.

Question 11

Answer 11

These inclusions can easily be mistaken for herpes, but the feature here is the halo effect caused by margination of the nuclear chromatin. This is classic for measles.

BRAIN. MEASELS. MARGINATION.

Question 12

Answer 12

In AIDS patients, mycobacterial infections often do not elicit the characteristic inflammatory response that I mentioned earlier, with granulomas and tissue destruction, and with organisms quarantined within the granulomas. Instead, the infection tends to be more diffuse with macrophages that are packed with the organisms.

Mycobacterium avium infection in a patient with AIDS showing massive diffuse infection with acid-fast organisms.

Question 13

Answer 13

Here’s one that we see pretty frequently, although this rarely occurs in the oral cavity. Cytomegalovirus causes the classic “owls eye” inclusion that’s intranuclear, and the ringed pattern actually represents a retraction artifact. CMV will also sometimes give dot-like cytoplasmic inclusions as well. Because CMV can cause disease in multiple organ systems (especially in immune compromised patients), we can see these inclusions in the gastrointestinal tract, lungs, kidneys, and brain.

Question 14

Answer 14

Here is what pneumocystis pneumonia looks like. The cup shaped organisms are often accompanied by a frothy proteinaceous exudate.

Silver stain.

Question 15

Answer 15

Finally, the last one I’ll mention is a cytoplasmic inclusion, called a negri body after the guy who first described them Adelchi Negri who was an Italian pathologist and microbiologist., These pink blobs are seen in the neurons in rabies. So those are some of the more common viral inclusions.

Brain.

Question 16

Answer 16

Thrush. Membrane is composed of fungal elements in a fibrinopurulent exudate.

Question 17

Answer 17

Thrush.