120 Photos - Apr 14, 2011
Photo: Tree-in-bud changes of atypical mycobacterial infectionPhoto: Discitis due to Mycobacterium kansasiiPhoto: Discitis due to Mycobacterium kansasiiPhoto: Otitis media with bullous myringitisPhoto: Otitis media with bullous myringitisPhoto: Otitis mediaPhoto: Burkitt's lymphoma due to Epstein Barr VirusPhoto: Burkitt's lymphoma due to Epstein Barr VirusPhoto: Black eschar of anthraxPhoto: Gelatinous eschar of cutaneous anthraxPhoto: Bacillus anthracis, Gram stain, "box cars"Photo: Bartonella henselae lesionsPhoto: Bartonella henselae lesionsPhoto: Bartonella henselae lesionsPhoto: Bartonella henselae, Warthin Starry stainPhoto: Photo: Bartonella henselaePhoto: Bartonella henselaePhoto: Human body lice, Pediculus humanus humanusPhoto: Pseudomonas uveitis after distant radial keratotomyPhoto: Pseudomonas uveitis after distant radial keratotomyPhoto: Pseudomonas uveitis after distant radial keratotomyPhoto: Facies of lepromatous leprosyPhoto: lepromatous leprosyPhoto: lepromatous leprosyPhoto: lepromatous leprosyPhoto: lepromatous leprosyPhoto: Giardia trophozoite in stoolPhoto: Group A Streptococcus - Scarlet fever - Classic retroauricular rashPhoto: Group A Streptococcus - Scarlet fever - fine, raised eruptionPhoto: Group A Streptococcus - Scarlet fever - sand-paper-like, fine, raised eruptionPhoto: Group A Streptococcus - Scarlet fever - erythema of creasesPhoto: Group A Streptococcus - Scarlet fever - circumoral pallorPhoto: Photo: Streptococci, Gram stain,  cocci in pairs and chainsPhoto: Erysipelas, Group A StreptococcusPhoto: Staphylococci, Gram stain, "grape clusters"Photo: Cellulitis, Methicillin-resistant Staphylococcus aureusPhoto: Conjunctival hemorrhages in bacterial endocarditisPhoto: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus)Photo: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus)Photo: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus)Photo: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus)Photo: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus), progressionPhoto: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus), progressionPhoto: Nodular lymphangitis with superimposed cellulitis in immunocompromised host (Mycobacterium abscessus), progressionPhoto: Yersinia pestis, plague, buboesPhoto: Phlebotomus sand flyPhoto: Cutaneous leishmaniasisPhoto: Cutaneous leishmaniasisPhoto: amastigotes of LeishmaniaPhoto: Photo: Photo: Babesia microti, "tetrad" of trophozoites in red blood cellPhoto: Plasmodium malariae, "band" form trophozoitePhoto: Babesia microti, "tetrad" of trophozoites in red blood cellPhoto: Plasmodium falciparum, multiple trophozoites in red blood cellsPhoto: Plasmodium falciparum, "banana-shaped" gametocytePhoto: Plasmodium vivax or P. ovale, "Schuffner's dots"Photo: Plasmodium vivax trophozoite in red blood cell, with basophilic stippling (due to anemia)Photo: Trypanosoma cruzi, "C shaped" trophozoitesPhoto: Trypanosoma bruceiPhoto: Trichinella encysted in skeletal musclePhoto: smallpox (Variola)Photo: Shingles (Varicella zoster) of 2nd branch, Trigeminal NervePhoto: Shingles (Varicella zoster) of 2nd branch, Trigeminal Nerve - note palatal involvementPhoto: Necrotizing furunculosis & adenitis in immunosuppressed patientPhoto: Necrotizing furunculosis & adenitis in immunosuppressed patientPhoto: Bullous cellulitisPhoto: Pityriasis rosea - characteristic central collarette of scale - This, the initial "herald patch", was the largest lesionPhoto: Pityriasis rosea - Initial lesion is papular, evolves to central pallor surrounded by collarette of scalePhoto: Pityriasis roseaPhoto: Reticulonodular infiltrates with patchy areas of "ground glass" attenuationPhoto: Reticulonodular infiltrates with patchy areas of "ground glass" attenuationPhoto: Reticulonodular infiltrates with patchy areas of "ground glass" attenuationPhoto: Nocardia pneumonia with cavitary nodule, smaller nodules, ground glass attenuation, in individual on chronic corticosteroidsPhoto: Diabetic foot infection (Rachel Irby MD)Photo: Southern Tick Associated Rash Illness (STARI) after a tick bitePhoto: Southern Tick Associated Rash Illness (STARI) after  tick bitesPhoto: Southern Tick Associated Rash Illness (STARI) after tick bitesPhoto: Acid fast bacilliPhoto: Anthrax skin infection - "gelatinous" edema around escharPhoto: Anthrax skin infection - "gelatinous" edema around escharPhoto: Anthrax - long Gram positive bacilliPhoto: Aspergillus - septate hyphae that branch at 45 degreesPhoto: Aspergillus - septate hyphae that branch at 45 degreesPhoto: Blastomyces - Broad-Based BuddingPhoto: Blastomyces - Broad-Based BuddingPhoto: Coccidioides imitis – yeast forms/spherules (which may be broken open to release endospores) in clinical specimensPhoto: Coccidioides imitis – yeast forms/spherules (which may be broken open to release endospores) in clinical specimensPhoto: Coccidioides imitis – yeast forms/spherules (which may be broken open to release endospores) in clinical specimensPhoto: Mold infection in immunocompromised host – air-crescent sign, a necrotized nodule (differential diagnosis includes non-invasive fungus ball or mycetoma, necrotic tumor)Photo: Cryptococcus – yeast forms in clinical specimens, usually very thick capsule, not much inflammation around it; the capsule isn’t visible in tissue but may make the yeast seem to be “floating” in the tissue.Photo: Cryptococcus – yeast forms in clinical specimens, usually very thick capsule, not much inflammation around it; the capsule isn’t visible in tissue but may make the yeast seem to be “floating” in the tissue.Photo: Cryptococcus (continued) India Ink stain of cerebrospinal fluid (enormous capsule)Photo: Gonorrhea in cervical secretions - Gram negative diplococci (kidney-shaped) in pairsPhoto: Gonorrhea in cervical secretions - Gram negative diplococci (kidney-shaped) in pairsPhoto: Gonorrhea in penile discharge - Gram negative diplococci (kidney-shaped) in pairs; note they are often in neutrophilsPhoto: Mold infection in immunocompromised host – diffuse halo sign surrounding a nodule or consolidative processPhoto: Histoplasmosis – It’s often found in histiocytes; big clusters of yeast forms. Compare discrete yeast forms to Leishmania amastigotes.Photo: Histoplasmosis – It’s often found in histiocytes; big clusters of yeast forms.Photo: Histoplasmosis – It’s often found in histiocytes; big clusters of yeast forms. Just keep looking, it's like an optical illusion—they'll pop out at you!Photo: Leishmania amastigotes – note kinetoplast + nucleus, unlike Histoplasma; also, the amastigotes may be less discretely seen than Histoplasma yeast forms.Photo: Mucor or Rhizopus mold - broad, ribbon-like hyphae, branching at 90 degreesPhoto: Mucor or Rhizopus mold - broad, ribbon-like hyphae, branching at 90 degreesPhoto: Nocardia - filamentous, "beaded" Gram positive rodsPhoto: Paracoccidioides - boat-wheel appearance of budding yeastsPhoto: Paracoccidioides - boat-wheel or daisy-like appearance of budding yeastsPhoto: Paracoccidioides - if a boat-wheel or daisy-like appearance is not seen, look for: buds are the same size as the parent yeast; a thin "spoke" from parent to bud; other buds sprouting in "3-D" from the parentPhoto: Pneumocystis on methenamine silver stain – note cupped forms and off-center thickening of cell wall (compare to the endospores in the Coccidioides images); note that Coccidioides may have "cupped" endospores, but you will usually see a capsule & no off-center thickened wall)Photo: Nocardia ulcer in immunosuppressed patient with brain abscessPhoto: Nocardia ulcer in immunosuppressed patient with brain abscessPhoto: extensive gastric ulcer, due to Rhizopus, in immunocompetent patientPhoto: 90 degree branching Rhizopus in gastric biopsyPhoto: Subcentimeter liver hypodensities in patient with miliary/reticulonodular lung findingsPhoto: Miliary/reticulonodular lesions in lung (DDx: TB, fungi, viral, sarcoid, pneumoconiosis, malignancyPhoto: lung abscess, with fluid levelPhoto: confluent, progressing lung abscesses with fluid levelPhoto: Septic olecranon bursitis, presenting acutely with pain, diffuse erythema, warmth, low grade temperature, and described by the patient as a "spider bite". Consistent with Staphylococcus aureus infection.Photo: Septic olecranon bursitis, presenting acutely with pain, diffuse erythema, warmth, low grade temperature, and described by the patient as a "spider bite". Consistent with Staphylococcus aureus infection.