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jirovĺcii causes clinically significant lesions in humans only in conditions of pronounced immunodeficiency, more often in premature newborns, patients with severe immunodeficiencies and patients with HIV infection in the late stages. Clinical diagnosis is based on signs of progressively increasing severe respiratory failure over weeks and months, combined with a minimal or moderate characteristic x-ray picture.
There are no available laboratory diagnostic methods. Cytological studies of bronchoalveolar lavage fluid or sputum are of great importance in clinical diagnosis.
Macroscopically, lungs with pneumocystosis may have characteristic features. In typical cases, this diagnosis can be established on the basis of unusually large non-collapsing lungs of "rubber" density, with a smooth,
During pneumocystis pneumonia, 3 stages are distinguished.
Microscopic examination from the edematous stage reveals very characteristic changes.
In the acute phase of the disease, pneumocysts are found on the surface of the mucous membrane of small bronchi, which stain well with the PAS reaction and, especially, with silver impregnation according to the Grocott method. The most typical is the accumulation of pneumocysts in the alveolar ducts and cavities of the alveoli. With a
In some cases, the development of fibrocystic
5. Features of the course and morphological diagnosis of toxoplasmosis in HIV infection. B20.8 With HIV infection, toxoplasmosis is most characteristic of brain lesions.
In the acute course of the process, toxoplasma is found both in nerve cells and extracellularly. Necrotic changes occur with a mild exudative, predominantly microglial reaction.
As a result of vascular damage, secondary focal aseptic colliquative necrosis is possible.
Subsequently, the necrotic tissue resolves with the formation of cysts. In addition to the brain, toxoplasmosis can also affect the lymph nodes, liver, and other organs.
6. Features of the course and morphological diagnosis of cryptococcosis in HIV infection. B20.5 Macroscopically, cryptococcosis can be suspected only with a massive lesion of the pia mater, when they thicken somewhat and acquire a "jelly-like" appearance. The main diagnostic value in pathoanatomical practice is acquired by a histological examination, in which, when stained with hematoxylin-eosin, rounded pale-colored formations close in size to an erythrocyte are determined.
For cryptococci, it is extremely characteristic to be found in "microcysts" in the substance of the brain and other organs with a minimal cellular reaction.