Cite this page: Mansouri J. Uncommon infections. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/spleenuncommoninfections.html. Accessed April 25th, 2024.
AIDS
- Prior to highly active antiretroviral therapy (HAART), typical findings were white pulp depletion, hemosiderin deposition, spindle cell proliferation and perivascular hyalinization; also infectious and malignant infiltrates (Mod Pathol 2002;15:406)
- Post-HAART findings include less frequent white pulp depletion but similar rates of splenic involvement by atypical mycobacteria and CMV in those with systemic disease
Hantavirus
- Rare but deadly disease transmitted to humans through aerosolized virus from rodent urine, droppings or saliva
- Usually causes pulmonary syndrome with acute respiratory distress syndrome
- Gross description: dense, rubbery and heavy lungs floating within yellow serous fluid within pleural cavity; no specific splenic findings
- Micro description: generalized capillary dilation and edema, immunoblasts in red pulp and periarteriolar sheaths of spleen, occasional prominent and swollen endothelial cells
Mycobacteria
- Small, weakly gram positive bacteria that are acid fast (due to mycolic acid in cell wall) and slow growers (3 - 4 weeks to develop a visible colony)
- Mycobacterium avium complex (MAC) consists of M. avium and M. intracellulare, which cause disseminated disease associated with advanced HIV; cause pulmonary disease and cervical lymphadenitis in immunocompetent individuals
- Disseminated MAC is most common systemic bacterial infection in HIV+ patients
- Spleen may show presence of pseudo-Gaucher cells (J Clin Pathol 2005;58:1113)
- Treatment: clarithromycin or azithromycin plus ethambutol, for life
Parvovirus
- Causes "fifth" disease in children, a mild illness with a "slapped cheek" facial rash
- Pregnant women may pass virus to fetus, where it causes marked fetal anemia and hydrops
- Attacks erythroblasts, affecting those with minimal reserve (sickle cell patients, fetuses)
Typhoid fever
Case reports
- 37 year old white man with advanced HIV and splenomegaly (Arch Pathol Lab Med 2001;125:697)
