medigraphic.com
ISSN 2500-7106 (Electronic)
ISSN 0123-2576 (Print)
Medicina & Laboratorio

2012, Number 11-12

<< Back Next >>

Medicina & Laboratorio 2012; 18 (11-12)

Gram stain of tissue biopsy: scope and pitfalls

Jiménez TGA, Vélez HA

Language: Spanish
References: 96
Page: 557-573
PDF size: 382.29 Kb.


ABSTRACT

The identification of microorganisms in tissue is pivotal to recognize infectious processes. At first, the hematoxylin-eosin stain is used to identify the pattern of inflammation associated; after that, microorganisms are seen through Gram or silver stains. Gram Stain of tissue biopsy not only stains bacteria, but also a number of fungus and parasites. However, this technique has some disadvantages, such as contamination with other microorganisms, and lack of stain of some bacteria, including Legionella pneumophila, Leptospira spp and Bartonella spp. This review article aims to describe the fundamentals of Gram stain of tissue biopsy and its assistance in infectious diagnosis as an additional tool for recognition of microorganisms, as well as its limitations.


REFERENCES

  1. Kradin RL. Diagnostic pathology of infectious disease. Philadelphia: Saunders Elsevier; 2010.

  2. Morris AJ, Drinkovic D, Pottumarthy S, Strickett MG, MacCulloch D, Lambie N, et al. Gram stain, culture, and histopathological examination findings for heart valves removed because of infective endocarditis. Clin Infect Dis 2003; 36: 697-704.

  3. Wilck MB, Wu Y, Howe JG, Crouch JY, Edberg SC. Endocarditis caused by culture-negative organisms visible by Brown and Brenn staining: utility of PCR and DNA sequencing for diagnosis. J Clin Microbiol 2001; 39: 2025-2027.

  4. Fartoukh M, Maitre B, Honore S, Cerf C, Zahar JR, Brun-Buisson C. Diagnosing pneumonia during mechanical ventilation: the clinical pulmonary infection score revisited. Am J Respir Crit Care Med 2003; 168: 173-179.

  5. Goldberg J. Studies on granuloma inguinale. V. Isolation of a bacterium resembling Donovania granulomatis from the faeces of a patient with granuloma inguinale. Br J Vener Dis 1962; 38: 99-102.

  6. Rice PA, Madico GE. Polymerase chain reaction to diagnose infective endocarditis: will it replace blood cultures? Circulation 2005; 111: 1352-1354.

  7. Woods GL, Walker DH. Detection of infection or infectious agents by use of cytologic and histologic stains. Clin Microbiol Rev 1996; 9: 382-404.

  8. Rudiger T, Geissinger E. [Infectious lymphadenitis]. Pathologe 2011; 32: 428-435.

  9. Sutinen S, Syrjala H. Histopathology of human lymph node tularemia caused by Francisella tularensis var palaearctica. Arch Pathol Lab Med 1986; 110: 42-46.

  10. Perkocha LA, Geaghan SM, Yen TS, Nishimura SL, Chan SP, Garcia-Kennedy R, et al. Clinical and pathological features of bacillary peliosis hepatis in association with human immunodeficiency virus infection. N Engl J Med 1990; 323: 1581-1586.

  11. Seidel G, Pardo CA, Newman-Toker D, Olivi A, Eberhart CG. Neurobrucellosis presenting as leukoencephalopathy: the role of cytotoxic T lymphocytes. Arch Pathol Lab Med 2003; 127: e374-377.

  12. Dahl R, Dans PE. Gonococcal lymphadenitis. Arch Intern Med 1974; 134: 116-117.

  13. Gould ES, Gilet AG, Vigorita VJ. Granulomatous salmonella osteomyelitis associated with anti-tumor necrosis factor therapy in a non-sickle cell patient: a case report. Skeletal Radiol 2010; 39: 821-825.

  14. Lamps LW, Madhusudhan KT, Greenson JK, Pierce RH, Massoll NA, Chiles MC, et al. The role of Yersinia enterocolitica and Yersinia pseudotuberculosis in granulomatous appendicitis: a histologic and molecular study. Am J Surg Pathol 2001; 25: 508-515.

  15. Kojima M, Morita Y, Shimizu K, Yoshida T, Yamada I, Togo T, et al. Immunohistological findings of suppurative granulomas of Yersinia enterocolitica appendicitis: a report of two cases. Pathol Res Pract 2007; 203: 115-119.

  16. Lucio E, Adesokan A, Hadjipavlou AG, Crow WN, Adegboyega PA. Pyogenic spondylodiskitis: a radiologic/ pathologic and culture correlation study. Arch Pathol Lab Med 2000; 124: 712-716.

  17. Smego RA, Jr., Foglia G. Actinomycosis. Clin Infect Dis 1998; 26: 1255-1261; quiz 1262-1253.

  18. Weinstock DM, Brown AE. Rhodococcus equi: an emerging pathogen. Clin Infect Dis 2002; 34: 1379- 1385.

  19. Hart CA, Rao SK. Rhinoscleroma. J Med Microbiol 2000; 49: 395-396.

  20. Richens J. The diagnosis and treatment of donovanosis (granuloma inguinale). Genitourin Med 1991; 67: 441-452.

  21. McDade JE, Shepard CC, Fraser DW, Tsai TR, Redus MA, Dowdle WR. Legionnaires’ disease: isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med 1977; 297: 1197-1203.

  22. Versalovic J. Helicobacter pylori. Pathology and diagnostic strategies. Am J Clin Pathol 2003; 119: 403-412.

  23. Hussein MR. Mucocutaneous Splendore-Hoeppli phenomenon. J Cutan Pathol 2008; 35: 979-988.

  24. Isa-Isa R, Arenas R, Fernandez RF, Isa M. Rhinofacial conidiobolomycosis (entomophthoramycosis). Clin Dermatol 2012; 30: 409-412.

  25. Kleinschmidt-DeMasters BK. Central nervous system aspergillosis: a 20-year retrospective series. Hum Pathol 2002; 33: 116-124.

  26. Padilla-Desgarennes C, Vazquez-Gonzalez D, Bonifaz A. Botryomycosis. Clin Dermatol 2012; 30: 397- 402.

  27. Read RW, Zhang J, Albini T, Evans M, Rao NA. Splendore-Hoeppli phenomenon in the conjunctiva: immunohistochemical analysis. Am J Ophthalmol 2005; 140: 262-266.

  28. Kukulj S, Mehulic M, Barisic B, Kamauf-Balabanic B, Krizanac S. Primary pulmonary botryomycosis: case report. Coll Antropol 2004; 28: 931-936.

  29. Schlossberg D, Pandey M, Reddy R. The Splendore- Hoeppli phenomenon in hepatic botryomycosis. J Clin Pathol 1998; 51: 399-400.

  30. Coelho WS, Diniz LM, Souza Filho JB. [Cutaneous botryomycosis: case report]. An Bras Dermatol 2009; 84: 396-399.

  31. Coulibaly B, Geraldine H, Le Hemon A, Gouriet F, Marie-Anne C. [Staphylococcus aureus isolated from a case of lymph node botryomycosis]. Arch Pediatr 2008; 15: 1440-1442.

  32. Bersoff-Matcha SJ, Roper CC, Liapis H, Little JR. Primary pulmonary botryomycosis: case report and review. Clin Infect Dis 1998; 26: 620-624.

  33. Wenig BM, Smirniotopoulos JG, Heffner DK. Botryomycosis (‘bacterial ball’) of the sinonasal tract caused by Pseudomonas aeruginosa. Arch Pathol Lab Med 1996; 120: 1123-1128.

  34. Kadyan RS. Botryomycosis. Indian J Dermatol Venereol Leprol 1996; 62: 157-158.

  35. Dasgupta P, Womack C, Turner AG, Blackford HN. Malacoplakia: von Hansemann’s disease. BJU Int 1999; 84: 464-469.

  36. Stanton MJ, Maxted W. Malacoplakia: a study of the literature and current concepts of pathogenesis, diagnosis and treatment. J Urol 1981; 125: 139-146.

  37. Scannell KA, Portoni EJ, Finkle HI, Rice M. Pulmonary malacoplakia and Rhodococcus equi infection in a patient with AIDS. Chest 1990; 97: 1000- 1001.

  38. Shaktawat SS, Sissons MC. Malakoplakia of the appendix, an uncommon entity at an unusual site: a case report. J Med Case Rep 2008; 2: 181.

  39. Matsui Y, Okada N, Nishizawa M, Kaneko H, Watanabe M, Miura Y, et al. An Osler’s node and a Janeway lesion. Intern Med 2009; 48: 1487-1488.

  40. Tang YW, Stratton CW. Staphylococcus aureus: An old pathogen with new weapons. Clin Lab Med 2010; 30: 179-208.

  41. Greene SL, Su WP, Muller SA. Ecthyma gangrenosum: report of clinical, histopathologic, and bacteriologic aspects of eight cases. J Am Acad Dermatol 1984; 11: 781-787.

  42. Ashton-Key M, Diss TC, Isaacson PG. Detection of Helicobacter pylori in gastric biopsy and resection specimens. J Clin Pathol 1996; 49: 107-111.

  43. Gram C. Über die isolierte Färbung der Schizomyceten in Schnitt- und Trockenpräparaten. Fortschritte der Medicin 1884; 2: 185-189.

  44. Woods AE, Ellis RC. Laboratory histopathology: a complete reference. Edinburgh: Churchill Livingstone; 1994.

  45. Engbaek K, Johansen KS, Jensen ME. A new technique for Gram staining paraffin-embedded tissue. J Clin Pathol 1979; 32: 187-190.

  46. Luna LG. Manual of Histologic Staining Methods of the Armed Forces Institute of Pathology (ed 3rd). New York: McGraw-Hill; 1968.

  47. Leaver RE, Evans BJ, Corrin B. Identification of Gram-negative bacteria in histological sections using Sandiford’s counterstain. J Clin Pathol 1977; 30: 290- 291.

  48. Ollett WS. A method for staining both gram-positive and gram-negative bacteria in sections. J Pathol Bacteriol 1947; 59: 357.

  49. Sowter C, Mc GZ. Evaluation of a new technique for the demonstration of gonococci and other micro-organisms in host cells. J Clin Pathol 1976; 29: 433-437.

  50. Procop GW, Wilson M. Infectious disease pathology. Clin Infect Dis 2001; 32: 1589-1601.

  51. Sandiford BR. Contrast Stain for Gonococci and Meningococci. Br Med J 1938; 1: 1155-1156.

  52. Williams MD, Bornemisza A. A modified Sandiford’s counter stain for smears of blood cultures. J Clin Pathol 1980; 33: 794-795.

  53. Dhiraputra C, Chavalittamrong B, Ratanarapee S. Advantage of Sandiford’s counterstain in detection of Gram negative bacteria in clinical specimens. Southeast Asian J Trop Med Public Health 1980; 11: 267-268.

  54. Kanafani ZA, Fowler VG, Jr. [Staphylococcus aureus infections: new challenges from an old pathogen]. Enferm Infecc Microbiol Clin 2006; 24: 182-193.

  55. Kotler DP, Sandkovsky U, Schlievert PM, Sordillo EM. Toxic shock-like syndrome associated with staphylococcal enterocolitis in an HIV-infected man. Clin Infect Dis 2007; 44: e121-123.

  56. Wilson AL, Kaufman MW, Thomson RB, Jr., Gavin PJ. Fulminant fatal toxic shock syndrome with Staphylococcus aureus. Am J Emerg Med 2007; 25: 225-226.

  57. Montes M, García JM. Género Streptococcus: una revisión práctica para el laboratorio de microbiología Enferm Infecc Microbiol Clin 2007; 25(Supl 3): 14-20.

  58. Pollard AJ, Finn A, British Paediatric Allergy I, European Society for Paediatric Infectious Diseases, Royal College of Paediatrics and Child Health. Hot topics in infection and immunity in children III. New York: Springer; 2006.

  59. Cramer SF, Tomkiewicz ZM. Septic pulmonary thrombosis in streptococcal toxic shock syndrome. Hum Pathol 1995; 26: 1157-1160.

  60. Gray-Owen SD, Dehio C, Rudel T, Naumann M, Meyer TF. Neisseria. In: Groisman EA, ed. Principles of Bacterial Pathogenesis. San Diego: Academic Press; 2001.

  61. Gotschlich EC. Gram-negative cocci, pathogenic. In: Schaechter M, ed. Encyclopedia of Microbiology (ed 3rd). Oxford: Academic Press; 2009.

  62. Byers JL, Bradley DF. Primary pustular gonorrhea of the skin. AMA Arch Derm Syphilol 1953; 68: 503- 505.

  63. Curry S. Clostridium difficile. Clin Lab Med 2010; 30: 329-342.

  64. Merla R, Reddy NK, Birnbaum Y, Qiu S, Ahmad M, Atar S. Clostridium perfringens: a rare cause of infective endocarditis and aortic root abscess. Hospital Physician 2008; 6: 23-27.

  65. Petit L, Gibert M, Popoff MR. Clostridium perfringens: toxinotype and genotype. Trends Microbiol 1999; 7: 104-110.

  66. Vitek CR. Diphtheria. Curr Top Microbiol Immunol 2006; 304: 71-94.

  67. Liebenberg SJ, White WA, Fagan JJ. A case report of an 11 year old boy with a fatal sore throat: Corynebacterium diphtheria - Does it still occur ? South Afr J Epidemiol Infect 2009; 24: 40-42.

  68. Drevets DA, Bronze MS. Listeria monocytogenes: epidemiology, human disease, and mechanisms of brain invasion. FEMS Immunol Med Microbiol 2008; 53: 151-165.

  69. Freitag NE, Port GC, Miner MD. Listeria monocytogenes - from saprophyte to intracellular pathogen. Nat Rev Microbiol 2009; 7: 623-628.

  70. Stefanovic A, Reid J, Nadon AC, Grant J. Potential nosocomial acquisition of epidemic Listeria monocytogenes presenting as multiple brain abscesses resembling nocardiosis. Can J Infect Dis Med Microbiol 2010; 21: 57-60.

  71. Bittencourt AL, Garcia AG. The placenta in hematogenous infections. Pediatr Pathol Mol Med 2002; 21: 401-432.

  72. Parkash V, Morotti RA, Joshi V, Cartun R, Rauch CA, West AB. Immunohistochemical detection of Listeria antigens in the placenta in perinatal listeriosis. Int J Gynecol Pathol 1998; 17: 343-350.

  73. Linder R. Rhodococcus equi and Arcanobacterium haemolyticum: two “coryneform” bacteria increasingly recognized as agents of human infection. Emerg Infect Dis 1997; 3: 145-153.

  74. Kaper JB, Nataro JP, Mobley HL. Pathogenic Escherichia coli. Nat Rev Microbiol 2004; 2: 123-140.

  75. House D, Bishop A, Parry C, Dougan G, Wain J. Typhoid fever: pathogenesis and disease. Curr Opin Infect Dis 2001; 14: 573-578.

  76. Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid fever. N Engl J Med 2002; 347: 1770-1782.

  77. Raffatellu M, Wilson RP, Winter SE, Baumler AJ. Clinical pathogenesis of typhoid fever. J Infect Dev Ctries 2008; 2: 260-266.

  78. Keynan Y, Rubinstein E. The changing face of Klebsiella pneumoniae infections in the community. Int J Antimicrob Agents 2007; 30: 385-389.

  79. Kerr KG, Snelling AM. Pseudomonas aeruginosa: a formidable and ever-present adversary. J Hosp Infect 2009; 73: 338-344.

  80. Kurkdjian PM, Bourrillon A, Holvoet-Vermau L, Bingen E. [Pathology of Haemophilus infections: current situation in pediatrics]. Arch Pediatr 2000; 7 Suppl 3: 551s-558s.

  81. Reidl J, Klose KE. Vibrio cholerae and cholera: out of the water and into the host. FEMS Microbiol Rev 2002; 26: 125-139.

  82. Enroth H, Engstrand L. Helicobacter pylori. In: Heggenhougen K, ed. International Encyclopedia of Public Health. Oxford: Academic Press; 2008.

  83. Banic M, Franceschi F, Babic Z, Gasbarrini A. Extragastric manifestations of Helicobacter pylori infection. Helicobacter 2012; 17 Suppl 1: 49-55.

  84. Campuzano-Maya G. Proof of an association between Helicobacter pylori and idiopathic thrombocytopenic purpura in Latin America. Helicobacter 2007; 12: 265-273.

  85. Campuzano-Maya G. Cure of alopecia areata after eradication of Helicobacter pylori: a new association? World J Gastroenterol 2011; 17: 3165-3170.

  86. Westblom TU, Madan E, Kemp J, Subik MA, Tseng J. Improved visualisation of mucus penetration by Campylobacter pylori using a Brown-Hopps stain. J Clin Pathol 1988; 41: 232.

  87. Perry LJ, Jakobiec FA, Zakka FR. Bacterial and mucopeptide concretions of the lacrimal drainage system: an analysis of 30 cases. Ophthal Plast Reconstr Surg 2012; 28: 126-133.

  88. Baker RD. The diagnosis of fungus diseases by biopsy. J Chronic Dis 1957; 5: 552-570.

  89. Horowitz EA. Diseases Caused by Nocardia Species. In: Enna SJ, Bylund DB, eds. xPharm: The Comprehensive Pharmacology Reference. New York: Elsevier; 2008.

  90. Mitropoulos P, Konidas P, Durkin-Konidas M. New World cutaneous leishmaniasis: updated review of current and future diagnosis and treatment. J Am Acad Dermatol 2010; 63: 309-322.

  91. Serra S, Jani PA. An approach to duodenal biopsies. J Clin Pathol 2006; 59: 1133-1150.

  92. Field AS. Light microscopic and electron microscopic diagnosis of gastrointestinal opportunistic infections in HIV-positive patients. Pathology 2002; 34: 21-35.

  93. Chen C, Gulati P, French SW. Pathologic quiz case: a patient with acquired immunodeficiency syndrome and an unusual biliary infection. Arch Pathol Lab Med 2003; 127: 243-244.

  94. Manhas DR, Mohri H, Hessel EA, 2nd, Merendino KA. Experience with surgical management of primary infective endocarditis: a collected review of 139 patients. Am Heart J 1972; 84: 738-747.

  95. Wijnbergen M, Van Mullem PJ. Effect of histological decalcifying agents on number and stainability of gram-positive bacteria. J Dent Res 1987; 66: 1029- 1031.

  96. Veinot JP. Native Cardiac Valve Pathology. Surg Pathol Clin 2012; 5: 327-352.




2020     |     www.medigraphic.com