Histopathological Diagnosis of Infectious Diseases: Experience From a Tertiary Care Center in a Sub-Saharan African Country

Abstract

Introduction

Infectious diseases are very common worldwide, especially in developing countries. In some instances, patients may present with atypical clinical symptoms requiring surgical resections for therapeutic or diagnostic purposes. In such circumstances, pathology (histopathology) remains a valuable diagnostic tool. Our aim is to report histopathological features of infectious diseases diagnosed at our pathology laboratory.

Methods

This is a retrospective study including infectious diseases histologically diagnosed at our pathology laboratory over a period of about 4 years. The histopathological diagnosis was performed on formalin-fixed, paraffin-embedded and hematoxylin and eosin-stained specimens.

Results

Over the period of our study, we registered 193 patients with infectious diseases with a mean age of 35.6 years ± 17.1 (range of 2-77 years). In 82 patients out of 182, the clinical diagnosis was suspicious for malignancy. The definitive histopathological diagnoses were: tuberculosis (n = 139), schistosomiasis (n = 30), mycetoma (n = 15), echinococcosis (n = 3), onchocerciasis (n = 2), aspergillosis (n = 2), and mucormycosis (n = 2). Lesions of tuberculosis were mainly extra-pulmonary tuberculosis, as only 8 lesions of 139 were pulmonary tuberculosis. The 3 main locations of tuberculosis were lymph nodes (n = 38), pleura (n = 32), and digestive system (n = 28). Schistosomiasis (n = 30) was the second most frequent infectious disease, with 12 patients that had extra-urinary locations. All lesions of mycetoma were located on the feet (4 patients with actinomycetoma and 11 with eumycetoma).

Conclusions

In tropical countries, pathologists are usually requested in the diagnosis of various infectious diseases as patients present often with clinical suspicion of malignancy.