The Surgical Pathologist's Role in the Diagnosis of Infectious Diseases

In most clinical settings, the detection and identification of microbial pathogens are best accomplished in the microbiology laboratory. However, in some situations histopathologic or cytopathologic examination of specimens can provide information of crucial importance to the diagnosis and management of patients who have an infectious disease. Under certain circumstances, the pathologist can rapidly establish a presumptive or definitive etiologic diagnosis; detect and identify unculturable pathogens; establish a diagnosis when cultures are negative or unavailable; 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 disease from the differential diagnosis. Furthermore, the surgical pathologist can play an important role in the intraoperative triage of limited biopsy material, insuring that appropriate tissue is submitted for microbiologic culture, routine histopathologic or cytopathologic examination, and specialized ancillary studies. (The J Histotechnol 18:191, 1995)