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MILNER
PECORA SOLOMON SOONG
ii
Danny A. Milner, Jr., MD, MSc (Epi), FCAP
Pathologist and Associate Director of Microbiology
Brigham and Women’s Hospital
Associate Professor of Pathology
Harvard Medical School
Department of Immunology and Infectious Diseases
Harvard T.H. Chan School of Public Health
Boston, Massachusetts
Nicole Pecora, MD, PhD
Fellow in Infectious Disease Pathology
Department of Pathology
Brigham and Women’s Hospital
Boston, Massachusetts
Isaac Solomon, MD, PhD
Resident, Anatomic Pathology
Department of Pathology
Brigham and Women’s Hospital
Harvard Medical School
Boston, Massachusetts
Thing Rinda Soong, MD, PhD, MPH
Resident, Anatomic and Clinical Pathology
Department of Pathology
Brigham and Women’s Hospital
Boston, Massachusetts
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1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899
DIAGNOSTIC PATHOLOGY: INFECTIOUS DISEASES ISBN: 978-0-323-37677-8
Copyright © 2015 by Elsevier. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/ permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.
Publisher Cataloging-in-Publication Data
Diagnostic pathology. Infectious diseases / [edited by] Danny A. Milner. 1st edition. pages ; cm Infectious diseases Includes bibliographical references and index. ISBN 978-0-323-37677-8 (hardback)
1. Communicable diseases--Pathophysiology--Handbooks, manuals, etc.
2. Communicable diseases--Diagnosis--Handbooks, manuals, etc. 3. Infection-­ pathophysiology--Handbooks, manuals, etc. I. Milner, Danny A. II. Title: Infectious diseases. [DNLM: 1. Communicable Diseases--pathology--Handbooks.
2. Communicable Diseases--diagnosis--Handbooks. WC 195] RC112.D526 2015
616.90475--dc23
Notices
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International Standard Book Number: 978-0-323-37677-8
Cover Designer: Tom M. Olson, BA
Printed in Canada by Friesens, Altona, Manitoba, Canada
Last digit is the print number: 9 8 7 6 5 4 3 2 1

Dedications

To my mother (and other mothers, Terrie and Dyann),
my father (and other fathers, Felix and Franz), my sister
(the best nurse in the whole world), and Alan for all of the knowledge, support, kindness, tolerance, and
honesty they have imparted on my journey.
I would like to extend a very special thanks to Dr. Sherif

Dr. Alejandro Velez Hoyos, and Dr. Atis Muehlenbachs
for their tireless support and innumerable contributions.
The production of this book was accomplished with
!
residents within arguably the most outstanding
department of pathology in the world, and I thank
"!!#
compassion, and dedication to the care of all patients
who enter our sphere.
DM
v
vi

Contributing Authors


Clinical Neuropathology Fellow Brigham and Women’s Hospital
Post-Doctoral Fellow
Dana Farber Cancer Institute
Harvard Medical School
Boston, Massachusetts
Eleanor Russell-Goldman, MD, PhD
Resident, Anatomic and Clinical Pathology
Department of Pathology
Brigham and Women’s Hospital
Boston, Massachusetts
Leigh Compton, MD, PhD
Resident, Anatomic Pathology
Department of Pathology
Brigham and Women’s Hospital
Boston, Massachusetts
Brian J. Hall, MD
Dermatopathologist
Miraca Life Sciences
Irving, Texas
Adjunct Clinical Assistant Professor
Department of Medical Education
University of North Texas Health Science Center
Fort Worth, Texas
Elizabeth A. Morgan, MD
Assistant Professor of Pathology
Department of Pathology
Brigham and Women’s Hospital
Harvard Medical School
Boston, Massachusetts
Michael G. Drage, MD, PhD
Resident, Anatomic Pathology
Department of Pathology
Brigham and Women’s Hospital
Boston, Massachusetts
Lenette L. Lu, MD, PhD
Clinical and Research Fellow
Department of Medicine, Division of Infectious Disease
Massachusetts General Hospital
Boston, Massachusetts
Sherif R. Zaki, MD, PhD
Chief, Infectious Disease Pathology Branch Center for Disease Control and Prevention
Atlanta, Georgia
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Preface

When I open any textbook of infectious disease pathology from my bookshelf, it is always like seeing an old friend. I know their stories and remember their faces, and it is good to see them, reminisce over their telling epics, and always learn something new. With rare exceptions, every book on my shelf covering infectious disease pathology is authored by someone whom I have either met in person or with whom I have (more often) a very strong bond of friendship. We are a small group, but the knowledge within the pages of these texts is essential to care for patients in every anatomic pathology practice in the world, even if you don’t encounter them on a daily basis.
With Franz von Lichtenberg’s Pathology of Infectious Diseases (Raven Press, 1991), we were handed a very useful manual for the practicing surgical pathologist on how to deal with infectious diseases. So valuable was this text that I have chosen to republish many of the images  of knowledge that have been published following Franz’s small text most commonly came   dream of being inundated with them (rather than the macabre specter of malignancy to which we grow numb). The books, again I regard them as very good friends, are comforting in their completeness and inspired me in this current work.
What we have attempted to present is a book that would capture the essence of the Franz   included microbiological correlates and made reference to molecular tests that are too rapid and too accurate to avoid anymore, even for those of us who may cling to the glass and the pink/purple hues of our craft. Our organization was based on how one might read a slide by  located. We have also taken a lot of time to try and explain those things that we simply cannot see — and thus not possibly accurately diagnose — with tissue alone.
As you peruse this book, please do also refer to the online versions of your favorite chapters, as additional information and images are often present. Infectious disease is a multidisciplinary all data must be incorporated to reach a diagnosis, and we have attempted to point   thoughts, comments, and recommendations on how this book can be better.
Danny A. Milner, Jr., MD, MSc (Epi), FCAP
Pathologist and Associate Director of Microbiology Brigham and Women’s Hospital Associate Professor of Pathology Harvard Medical School Associate Professor Department of Immunology and Infectious Diseases Harvard T. H. Chan School of Public Health Boston, Massachusetts
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