咽部特殊感染症病理特点及病原体检测的探讨

目的 探讨咽部特殊感染性疾病的病理特点,研究其病原体的检测方法,以提高特殊感染症的诊断水平.方法 分析北京同仁医院1998年1月至2008年1月咽部61例黏膜溃疡病患者的临床病理资料,以简易的组织芯片染色技术,对61例咽部黏膜溃疡组织,用PAS、Giemsa、革兰、美蓝、改良的Warthin-Starry(W-S)及抗酸染色进行集中染色,比较各种染色方法对病原体的染色效果,找出不同病原体的最佳染色方法.结果 组织切片内发现密螺旋体23例,短螺旋体10例,分枝杆菌4例,鼻硬结杆菌4例,霉菌侵袭1例,细菌和白色念珠菌混合感染1例,扁桃陷窝放线菌2例.非特异性细菌感染16例.结论 螺旋体、鼻硬结杆菌均以改良的W-S染色效果最佳,真菌染色应根据真菌的不同类型联合应用革兰及PAS、W-S染色进行鉴别,分枝杆菌以传统的抗酸染色效果最好.

Pathologic diagnosis of specific infections in upper aerodigestive tract

Objective To find a fast and simple method for detection of specific pathogens in upper aerodigestive tract.Methods Sixty-one cases of specific infections in upper aerodigestive tract encountered during a 10-year period in Beijing Tongren Hospital were retrospectively studied.Six histochemical stains, including PAS, Giemsa, Gram, methylene blue, modified Warthin-Starry and acid-fast stains were applied.The morphology of different pathogens was studied and the staining patterns were compared.Results There were 23 cases of pharyngeal treponemal infection, 10 cases of short treponemal infection, 4 cases of mycohacterial infection, 4 cases of infection by rhinoscleroma bacilli, 1 case of sinonasal fungal infection, 1 case of combined infection of bacteria and Oidium albicans, 2 cases of tonsillar Actinomycetes and 16 cases of non-specific bacterial infections.Both pharyngeal treponemal infection and infection by rhinoscleroma bacilli could be detected by modified Warthin-Starry stain.As for sinonasal fungal infection, PAS, Giemsa and modified Warthin-Starry stains were useful in differentiating different types of fungi.Mycobacteria were best demonstrated by conventional acid-fast stain.Conclusions Special histochemical stains performed on histolngic sections are useful for diagnosing specific infections in upper aerodigestive tract.