—  SPECIALTY CONFERENCE  —

Infectious Disease Pathology
Monday, March 26, 2007, 7:30 PM
Convention Center 4





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Moderator:

GARY W. PROCOP
University of Miami School of Medicine
Miami, FL




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Case 1

Submitted by: Sherif Zaki - Centers for Disease Control, Atlanta, GA

Clinical Summary:

A previously healthy 4 year old female from New York had a two day history of abdominal pain and vomiting. She was not seen by a medical provider. The parents last saw the child alive on the early morning of March 1, 2004 but found her dead in bed later that morning. No information on travel history or other significant exposure could be obtained.


Case 1 - Slide 1
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Case 1 - Slide 2
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Case 1 - Figure 1

Case 1 - Figure 2

Case 1 - Figure 3

Case 1 - Figure 4

Case 1 - Figure 5




Case 2

Submitted by: Michael L. Wilson - Denver Health Medical Center, Denver, CO

Clinical Summary:

A 30 year-old pregnant female at 15 weeks gestation presented with fevers, chills, and right lower quadrant pain. The clinical diagnosis was pelvic inflammatory disease versus acute appendicitis. The patient underwent laparotomy and appendectomy as the appendix was visibly inflamed. Thre was also visible inflammation of the right fallopian tube and ovary. The pathologic diagnosis was acute periappendicitis with a comment that the inflammation was peri-appendiceal only and thus a source of infection elsewhere in the abdomen or pelvis should be considered. Two and one-half weeks later the patient presented with vaginal bleeding and reported a continuation of fevers and chills since the appendectomy. There was no evidence of a surgical site infection. The patient went into spontaneous labor and delivered a non-viable fetus. Images 1-2 are of placenta; images 3-5 are of appendix, all H&E at 200X magnification.


Case 2 - Figure 1

Case 2 - Figure 2

Case 2 - Figure 3

Case 2 - Figure 4

Case 2 - Figure 5




Case 3

Submitted by: Ann M. Nelson - Armed Forces Institute of Pathology, Washington, DC

Clinical Summary:

Penis, bx:

57 y/o man with AIDS
  • CD4 =243 (was 20)
  • Chronic, severe penile ulcerations
  • Hx of HSV penile foreskin
  • Empiric RX for HSV, fungi - no improvement
  • On HAART: Lopinavir, Efavirenz, Abacavir, Tenfovir
  • Low HIV viral loads (previously >750,000 copies)



Case 3 - Slide 1
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Case 3 - Figure 1

Case 3 - Figure 2

Case 3 - Figure 3

Case 3 - Figure 4

Case 3 - Figure 5




Case 4

Submitted by: Carol Farver - Cleveland Clinic Foundation, Cleveland, OH

Clinical Summary:

The patient is a 57 year-old white female, 4 months status post single lung transplantation (donor/recepient CMV+) for emphysema secondary to smoking, who presented with increasing shortness of breath which progressed to complete opacification and diffuse infiltration of the transplanted lung by chest X-ray. The patient was taken to open biopsy due to a rapidly declining respiratory status.


Case 4 - Figure 1
H&E stain

Case 4 - Figure 2
H&E stain



Case 4 - Figure 3
H&E stain

Case 4 - Figure 4
Immunohistochemical study from the open lung biopsy

During the meeting the slides and protocols will be available for study in the microscope room in the Manchester Grand Hyatt (Betsy A-C) for participants who wish to review them prior to the evening session.

Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting. However, we will provide a booklet at the meeting which will have a page for each Specialty Conference, listing the names of speakers and space for the important "take home messages".