Skip to main content Accessibility help
  • Print publication year: 2000
  • Online publication date: January 2013

3 - Infectious diseases


Introduction and background

Lower respiratory tract infections (LRTIs) are the leading cause of infectious deaths worldwide. In certain patient populations, for example, those with acquired immune deficiency syndrome (AIDS), it continues to be the most common cause of death. The vast majority of LRTIs that cause significant morbidity and mortality are bacterial and viral pneumonias in immunocompetent patients. These infections are more often diagnosed by clinical and laboratory findings alone. Fungal infections are the third most common type of LRTI and occur most frequently in immunocompromised patients (ICPs). Parasitic LRTIs are not infrequently encountered in people inhabiting tropical areas of Asia and Africa but they are exceedingly rare in most developed countries.

Mediastinal infections (MIs) occur much less frequently than LRTIs but are considered a surgical emergency and are associated with a very high mortality rate. In ICPs, acute bacterial infections are the most common followed by fungal infections. Parasitic infections very rarely involve this anatomical site.

Further reading
Atkins, KAPowers, CNThe cytopathology of infectious diseasesAdv Anat Pathol 2002 9 52
Bartlett, JGInfectious pneumonia in the patient with HIV infectionDis Clin North Am 1998 12 807
Clavel, AArnal, ACSánchez, ECRespiratory cryptosporidiosis: case series and review of the literatureInfection 1996 24 341
Crapanzano, JPZakowski, MFDiagnostic dilemmas in pulmonary cytologyCancer 2001 93 364
Das, RDey, PChakrabarti, ARay, PFine-needle aspiration biopsy in fungal infectionsDiagn Cytopathol 1997 16 31
Dugan, JMAvitabile, AMRossman, MDErnst, CSAtkinson, BFDiagnosis of pneumonia by cytologic evaluation of Papanicolaou-stained bronchial specimensDiagn Cytopathol 1988 4 106
Eyzaguirre, EHaque, AKApplication of immunohistochemistry to infectionsArch Pathol Lab Med 2008 132 424
Fischler, DFHall, GSGordon, SStoler, MHNunez, C in cytology specimens: a review of 45 specimens from 36 patientsDiagn Cytopathol 1997 16 26
Gallardo, JSasal, MFerreres, JCDiagnosis of histoplasmosis in bronchoalveolar lavage fluidActa Cytol 1995 39 595
Glazer, MNusair, SBreuer, RThe role of BAL in the diagnosis of pulmonary mucormycosisChest 2000 117 279
Hsu, CYCytologic diagnosis of pulmonary cryptococcosis in immunocompetent hostsActa Cytol 1993 37 667
Joos, LChhajed, PNWallner, JPulmonary infections diagnosed by BAL: a 12-year experience in 1066 immunocompromised patientsRespir Med 2007 101 93
Khan, RSharma, OPBronchial lavage in tropical pneumoniasCurr Opin Pulm Med 2007 13 225
Kuzucu, AParasitic diseases of the respiratory tractCurr Opin Pulm Med 2006 12 212
Lapkus, OElsheikh, TMUjevich, BALiu, YLSilverman, JFPitfalls in the diagnosis of herpes simplex infection in respiratory cytologyActa Cytol 2006 50 617
Lemos, LBBaliga, MTaylor, BDCason, ZJLucia, HLBronchoalveolar lavage for diagnosis of fungal disease: Five years’ experience in a southern United States rural area with many blastomycosis casesActa Cytol 1995 39 1101
Links, Vijayan VKHow to diagnose and manage common parasitic pneumoniasCurr Opin Pulm Med 2007 13 218
Linksvon, Sinner WNNew diagnostic signs in hydatid disease; radiography, ultrasound, CT and MRI correlated to pathologyEur J Radiol 1991 12 150
Raab, SSSilverman, JFZimmerman, KGFine-needle aspiration biopsy of pulmonary coccidiodomycosis: Spectrum of cytologic findings in 73 patientsAm J Clin Pathol 1993 99 582
Rolston, KVRodriguez, SDholakia, NWhimbey, ERaad, IPulmonary infections mimicking cancer: a retrospective, three-year reviewSupport Care Cancer 1997 5 90
Silverman, JFGay, RMFine-needle aspiration and surgical pathology of infectious lesions: Morphologic features and the role of the clinical microbiology laboratory for rapid diagnosisClin Lab Med 1995 15 251
Tani, EMSchmitt, FCOliveira, MLGobetti, SMDecarlis, RMPulmonary cytology in tuberculosisActa Cytol 1987 31 460
Travis, WDColby, TVKoss, MNAtlas of nontumor pathology, 1st series, Fascicle 2: Non-neoplastic disorders of the lower respiratory tractWashington DCAmerican Registry of Pathology 2002
Walsh, TJBerkman, WBrown, NL 1983 671
Woods, GLSpecimen collection and handling for diagnosis of infectious diseasesHenry, JBClinical diagnosis and management by laboratory methodsPhiladelphiaWB Saunders 2001
Woods, GLWalker, DHDetection of infection or infectious agents by use of cytologic and histologic stainsClin Microbiol Rev 1996 9 382
Yildiz, ODoganay, MActinomycoses and Nocardia pulmonary infectionsCurr Opin Pulm Med 2006 12 228