Infective disorders of the gastrointestinal tract

Abstract

Gastrointestinal infections are a major cause of morbidity and mortality worldwide. Infectious organisms are often recovered by microbiological methods, but surgical pathologists may play a very valuable role in diagnosis. This review will focus on infective disorders of the gastrointestinal tract with an emphasis on enterocolitides caused by food- and water-borne pathogens. Diagnostic histological features of selected enteric infections will be emphasized, including those that mimic other inflammatory conditions of the gut (such as ischaemia or idiopathic inflammatory bowel disease), along with available diagnostic methods that can aid in diagnosis.

Figure 1

Numerous plasma cells in the lamina propria and increased intraepithelial lymphocytes may be seen in resolving infectious colitis, mimicking lymphocytic colitis (H&E).

Figure 2

Culture and polymerase chain reaction‐proven Campylobacter colitis featuring well‐developed neutrophilic cryptitis, a neutrophilic infiltrate in the lamina propria and preservation of crypt architecture (H&E).

Figure 3

Salmonella typhi infection featuring mucosal ulceration, crypt abscesses and marked architectureal distortion, overlying a Peyer patch (H&E). Case courtesy of Dr A. Brian West.

Figure 4

Epithelioid granulomas with prominent lymphoid cuffs in a case of polymerase chain reaction‐proven Yersinia enterocolitica (H&E).

Figure 5

Culture‐proven case of Aeromonas infection featuring focal cryptitis and architectural distortion from a right colon biopsy (H&E).

Figure 6

Biopsy from a case of Escherichia coli O157:H7 showing lamina propria hyalinization, crypt withering, neutrophilic inflammation in the mucosa and fibrin thrombi (H&E).