Infectious diseases of the upper gastrointestinal tract

Abstract

A broad spectrum of pathogens produce gastrointestinal disease. The ongoing spread of human immunodeficiency virus/acquired immune deficiency syndrome, the increased use of immunosuppressive therapy and the persistence of overcrowding and suboptimal sanitation in underdeveloped areas facilitate both disease transmission from environmental and foodborne sources and person‐to‐person transmission. Clinicians increasingly rely on endoscopic biopsy sample interpretation to diagnose gastrointestinal infections. Thus, pathologists must be aware of diagnostic features of a variety of microbial pathogens. Detection with molecular techniques also allows for correlation between infectious agents and their histopathological features, which has expanded our knowledge of the inflammatory changes produced by infectious agents. This review covers infectious disorders of the upper gastrointestinal tract encountered in surgical pathology. Clinical, endoscopic and pathological features are presented. The review emphasises morphological features of viruses, bacteria, fungi and parasites that may be found in tissue samples, and the inflammatory patterns that they produce. Differential diagnoses and useful ancillary techniques are discussed.

Endoscopic Findings of Gastric Cryptococcosis in an Immunosuppressed Patient

“…In addition, Grocott-Gomori methenamine silver stain was used, which confirmed the yeast-like structures. 9 Prognosis in these patients is very poor, usually because of disseminated infection and marked immunosuppressed states. Our patient had a fatal outcome attributable to complications during hospitalization.…”

Pathologie infectieuse du tube digestif : diagnostics à ne pas manquer

“…La maladie de Whipple est causée par une bactérie T. Whipplei , de transmission oro-fécale, identifiée le plus souvent dans des stations d’épuration. Son atteinte la plus connue est digestive, touchant préférentiellement le duodénum, se manifestant le plus souvent par une diarrhée aqueuse, parfois accompagnée de méléna ou de stéatorrhée et pouvant se compliquer d’une perte de poids, voire d’œdèmes périphériques consécutifs à une hypoprotidémie [8] .…”

“…Cette atteinte digestive est associée à des adénopathies abdominales chez 45 % des patients. Après l’atteinte digestive, la maladie diffuse avec des atteintes cérébrales, cardiaques ou pulmonaires [8] .…”

Histopathology of intestinal villi in neonatal and paediatric age: main features with clinical correlation - Part II

“…A final note of caution must be issued when examining biopsies of the small intestine in which a prominent macrophage infiltrate is recognized; careful examination and use of special stains can help differentiate storage disorders from the more common infections by intracellular microorganisms: Tropheryma whipplei (PAS-D-positive, Acid-fast-negative) and Mycobacterium avium complex (Acid-fast-positive, PAS-D-negative) are the most common conditions that must be excluded 69 .…”