Ja. Reed et al., DUAL ORGANISM INFECTION IN BIOPSY SPECIMENS FROM IMMUNOCOMPROMISED PATIENTS - 2 CASES DEMONSTRATED BY IMMUNOCYTOCHEMISTRY, Journal of clinical laboratory analysis, 7(3), 1993, pp. 168-173
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.