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Misdiagnosis caused by fungal contaminant in a histological stain solution.

Abstract
Silver stains on tissue and cytology specimens are important in the evaluation of patients with suspected fungal infections. Care must be taken, however, to prevent misinterpretation of contamination artifacts. Two cases presenting such a problem are reported. The first patient had granulomatous leg lesions that microscopically showed characteristics of erythema induratum but with budding yeastlike organisms demonstrated by Grocott methenamine silver stain. Cultures and subsequent biopsies were negative for fungi. The second patient had a steroid-dependent chronic obstructive lung disease, and during evaluation for possible Pneumocystis carinii pneumonia, the Grocott methenamine silver stain on expectorated sputum showed budding yeastlike organisms. Sputum cultures were negative for fungi. Examination of the two Grocott light-green counterstain solutions demonstrated black, budding yeast cells similar to those seen in the specimens from the patients. Culture of the counterstain grew Exophiala (Phialophora) jeanselmei. Further studies revealed that this cause of misdiagnosis could be prevented by either filtering or adding thymol to the counterstain solution. Care regarding contamination of histological stain solutions is emphasized.
AuthorsD H McGregor, G R Hodges, W G Barnes, J W Brandsberg, S H Lee, N H Brugger
JournalJournal of clinical microbiology (J Clin Microbiol) Vol. 11 Issue 2 Pg. 174-7 (Feb 1980) ISSN: 0095-1137 [Print] United States
PMID6153661 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Silver
Topics
  • Granuloma (diagnosis)
  • Humans
  • Lung Diseases (diagnosis)
  • Male
  • Middle Aged
  • Mitosporic Fungi (growth & development)
  • Mycoses (diagnosis)
  • Silver
  • Staining and Labeling

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