5.2.2.4 Cryptococcosis complicated in an immunocompromised state

Cutaneous lesions occur in 10-20% of life-threatening disseminated cryptococcosis seen in immunocompromised patients [51]. Opportunistic skin infection of Cryptococcus neoformans occurred in a young patient after chemotherapy and steroid

administration against acute lymphoblastic leukemia. Transparent yeasts were floating in mucoid material, and inflammatory reaction was poor. The patient's own serum diluted at 1:10 was weakly reactive to the pathogen (Figure 29) [20, 21, 23].

own serum visualizes the fungal microbes phagocytized by macrophages.

Cutaneous alternariosis (left upper, gross appearance of the elbow; right upper, H&E; left lower, Grocott stain; right lower, reactivity with patient's own serum). Biopsy specimen from the brown-colored skin infiltrate contains a few Grocott-reactive fungi, Alternaria alternata, in the chronically inflamed dermis. The patient's

Malassezia (Pityrosporum) folliculitis and commensal fungi in the hair follicle (upper panels, malassezial folliculitis; lower panels, a commensal in a normal hair follicle adjacent to intradermal nevus; left, H&E; right, reactivity with patient's serum). A dilated hair follicle in biopsy material is disrupted by suppurative granuloma formation. The patient's own serum reacted with yeast-like fungi infected in the lesion. Commensal malassezial cells in the hair follicle of normal seborrheic skin, sampled from another individual, are strongly

Low-Specificity and High-Sensitivity Immunostaining for Demonstrating Pathogens…

DOI: http://dx.doi.org/10.5772/intechopen.85055

Biopsy was taken from the vesicular skin lesion of lethal hemorrhagic varicella

(small pox). The patient was a young boy suffering from intractable acute

5.2.3 Viral infection

Figure 28.

93

Figure 27.

labeled with the same serum.

5.2.3.1 Hemorrhagic varicella

#### Figure 26.

Sporotrichosis (left, periodic acid-Schiff reaction; right, reactivity with patient's own serum). Suppurative granulomas are formed in the dermis. Periodic acid-Schiff-reactive small yeast-like fungal cells are phagocytized by macrophages or multinucleated giant cells and are reactive with the patient's own serum.

Low-Specificity and High-Sensitivity Immunostaining for Demonstrating Pathogens… DOI: http://dx.doi.org/10.5772/intechopen.85055

#### Figure 27.

5.2.2 Fungal infection

Immunohistochemistry - The Ageless Biotechnology

5.2.2.1 Sporotrichosis

5.2.2.2 Malassezia folliculitis

5.2.2.3 Cutaneous alternariosis

Figure 26.

92

Sporotrichosis, skin infection of a dimorphic fungus Sporothrix schenckii particularly endemic in tropical and subtropical areas, is mediated by traumatic inoculation from soil or plants [48]. Skin biopsy material of sporotrichosis shows suppurative granuloma formation in the dermis. Periodic acid-Schiff-reactive small yeast-like fungal cells phagocytized by macrophages or multinucleated giant cells

Malassezia (Pityrosporum) folliculitis commonly seen on the face and upper portion of the trunk has been confused with acne vulgaris [49]. A dilated hair follicle in the biopsy material was infiltrated by neutrophils and epithelioid cells forming suppurative granuloma. The patient's own serum reacted to Grocottpositive yeast-like fungi in the lesion (Figure 27) [21, 23]. Malassezial bodies, a commensal in the hair follicle of normal seborrheic skin sampled from another

Alternaria is a nonpathogenic, melanin-forming fungus widely seen in the envi-

Cutaneous lesions occur in 10-20% of life-threatening disseminated cryptococcosis seen in immunocompromised patients [51]. Opportunistic skin infection of Cryptococcus neoformans occurred in a young patient after chemotherapy and steroid

Sporotrichosis (left, periodic acid-Schiff reaction; right, reactivity with patient's own serum). Suppurative granulomas are formed in the dermis. Periodic acid-Schiff-reactive small yeast-like fungal cells are phagocytized by macrophages or multinucleated giant cells and are reactive with the patient's own serum.

ronment. Rarely, skin infection of A. alternata happens [50]. In a skin biopsy specimen from a young female, a few Grocott-reactive fungi were observed in the chronically inflamed dermis. The patient's own serum visualized the fungal

were reactive with the patient's own serum (Figure 26) [20, 21, 23].

patient, were strongly labeled with the same serum.

microbes phagocytized by macrophages (Figure 28) [21, 23].

5.2.2.4 Cryptococcosis complicated in an immunocompromised state

Malassezia (Pityrosporum) folliculitis and commensal fungi in the hair follicle (upper panels, malassezial folliculitis; lower panels, a commensal in a normal hair follicle adjacent to intradermal nevus; left, H&E; right, reactivity with patient's serum). A dilated hair follicle in biopsy material is disrupted by suppurative granuloma formation. The patient's own serum reacted with yeast-like fungi infected in the lesion. Commensal malassezial cells in the hair follicle of normal seborrheic skin, sampled from another individual, are strongly labeled with the same serum.

#### Figure 28.

Cutaneous alternariosis (left upper, gross appearance of the elbow; right upper, H&E; left lower, Grocott stain; right lower, reactivity with patient's own serum). Biopsy specimen from the brown-colored skin infiltrate contains a few Grocott-reactive fungi, Alternaria alternata, in the chronically inflamed dermis. The patient's own serum visualizes the fungal microbes phagocytized by macrophages.

administration against acute lymphoblastic leukemia. Transparent yeasts were floating in mucoid material, and inflammatory reaction was poor. The patient's own serum diluted at 1:10 was weakly reactive to the pathogen (Figure 29) [20, 21, 23].

## 5.2.3 Viral infection
