Miranda L H M, Quintella L P, Santos I B, Oliveira R V C, Menezes R C, Figueiredo F B, Schubach T M P
Laboratório de Pesquisa Clínica em Dermatozoonoses em Animais Domésticos, Instituto de Pesquisa Clínica Evandro Chagas/Fundação Oswaldo Cruz (IPEC/FIOCRUZ), Av. Brasil 4365, Manguinhos, Rio de Janeiro, Brazil.
J Comp Pathol. 2010 Jul;143(1):1-7. doi: 10.1016/j.jcpa.2009.12.010. Epub 2010 Jan 25.
Pyogranulomatous lesions from 80 dogs with sporotrichosis and 26 dogs with American tegumentary leishmaniasis (ATL) were compared microscopically in order to identify features that would support the diagnostic suspicion and direct the subsequent search for the aetiological agent of either infection. Odds ratios and their respective 95% confidence intervals were calculated in order to evaluate the impact of the microscopical findings on the diagnosis of either disease. Lesions with well-formed granulomata were 14 times more likely to be due to sporotrichosis than ATL. Marked neutrophil infiltration into granulomata was 12.26 times more likely to be associated with sporotrichosis when compared with lesions having mild neutrophilic infiltration. Absence of lymphocytes and macrophages in the peripheral infiltrate was associated with a 9.71 and 4.93 higher chance, respectively, of being sporotrichosis rather than ATL compared with lesions where these cells were present. Lesions with a perivascular, perifollicular and interstitial peripheral inflammatory infiltrate were 5.48 times more likely to be due to sporotrichosis than ATL when compared with lesions with a diffuse peripheral infiltrate. Histopathological analysis may therefore contribute to the diagnosis of sporotrichosis or ATL skin lesions in dogs since this method permits the identification of features that direct the diagnostic suspicion, thus facilitating the search for the aetiological agent in histological sections, permitting the precise request of subsequent tests and thereby reducing costs and time taken to achieve a definitive diagnosis and the initiation of appropriate therapy.
对80只患有孢子丝菌病的犬和26只患有美洲皮肤利什曼病（ATL）的犬的脓性肉芽肿病变进行了显微镜检查比较，以确定有助于支持诊断怀疑并指导后续寻找任何一种感染病原体的特征。计算比值比及其各自的95%置信区间，以评估显微镜检查结果对这两种疾病诊断的影响。形成良好肉芽肿的病变由孢子丝菌病引起的可能性是由ATL引起的14倍。与轻度中性粒细胞浸润的病变相比，肉芽肿中有明显中性粒细胞浸润与孢子丝菌病相关的可能性高12.26倍。与存在淋巴细胞和巨噬细胞的病变相比，外周浸润中无淋巴细胞和巨噬细胞分别使病变由孢子丝菌病而非ATL引起的可能性高9.71倍和4.93倍。与具有弥漫性外周浸润的病变相比，具有血管周围、毛囊周围和间质外周炎性浸润的病变由孢子丝菌病引起的可能性是由ATL引起的5.48倍。因此，组织病理学分析可能有助于犬孢子丝菌病或ATL皮肤病变的诊断，因为这种方法可以识别有助于指导诊断怀疑的特征，从而便于在组织切片中寻找病原体，允许精确请求后续检测，从而降低成本以及确诊和开始适当治疗所需的时间。
