THE SURGICAL PATHOLOGISTS ROLE IN THE DIAGNOSIS OF INFECTIOUS-DISEASES

In most clinical settings, the detection and identification of microbi al pathogens are best accomplished in the microbiology laboratory. How ever, in some situations histopathologic or cytopathologic examination of specimens can provide information of crucial importance to the dia gnosis and management of patients who have an infectious disease. Unde r certain circumstances, the pathologist can rapidly establish a presu mptive or definitive etiologic diagnosis; detect and identify uncultur able pathogens; establish a diagnosis when cultures are negative or un available; evaluate the pathogenic significance of a cultural isolate; define the diagnostic criteria, pathogenesis, and morphologic spectra of ''new'' infectious diseases; and even exclude an infectious diseas e from the differential diagnosis. Furthermore, the surgical pathologi st can play an important role in the intraoperative triage of limited biopsy material, insuring that appropriate tissue is submitted for mic robiologic culture, routine histopathologic or cytopathologic examinat ion, and specialized ancillary studies.