DUAL ORGANISM INFECTION IN BIOPSY SPECIMENS FROM IMMUNOCOMPROMISED PATIENTS - 2 CASES DEMONSTRATED BY IMMUNOCYTOCHEMISTRY

We report two cases in which immunocytochemistry demonstrated simultan eous infections within a single biopsy specimen obtained from each of two immunocompromised patients in whom multiple organism infection was not suspected. Using a rapid immunocytochemical technique, Pneumocyst is carinii and Cryptococcus neoformans were demonstrated in a transbro nchial lung biopsy from the first patient; Candida and cytomegalovirus were demonstrated in an endoscopic biopsy of the esophagus from the s econd patient. Routine hematoxylin and eosin as well as special stains failed to establish the presence of more than one infectious agent in either case. Mycology cultures ultimately confirmed the presence of C ryptococcus in the first case, but cultures were not performed in the second case due to the scant amount of tissue obtained from the biopsy . The results indicate that concurrent infection by more than one oppo rtunistic organism in immunocompromised patients can easily remain unr ecognized. The use of immunocytochemistry may thus provide an importan t adjunct to routine and special stains or specific cultures.