Autopsy Findings of Nonacid-Fast Bacteria in Scleroderma

Abstract

Microscopic tissue sections stained for bacteria were studied from autopsy material from a fatal case of scleroderma (progressive systemic sclerosis). Extra- and intracellular, variable-sized, pleomorphic but predominantly coccoid bacteria were observed in some organs such as in heart, lungs, adrenals, kidneys, pancreas, skin, and in the connective tissue. An attempt is made to correlate the ante-mortem skin culture material with the post-mortem histopathologic finding of bacteria. It is hypothesized that these microbes observed in tissue might represent in vivo, cell wall deficient L forms, which may be implicated in the pathogenesis of scleroderma.

Necroscopic Findings of Pleomorphic, Variably Acid‐Fast Bacteria in a Fatal Case of Kaposi's Sarcoma

“…Although highly controversial, studies by a number of different investigators have suggested that pleomorphic acid‐fast bacteria (possibly in a cell‐wall‐deficient, L form phase) may be associated with malignancy 8–15 and also with certain collagen diseases 18–20 . Possibly relevant to these studies are recent reports that indicate that cell‐wall‐deficient forms of staphylococcal, streptococcal, and corynebacteria‐like organisms may be universally present in the bloodstream of human beings 21–24 .…”

Variably Acid‐Fast Pleomorphic Bacteria as a Possible Cause of Mycosis Fungoides: A Report of a Necropsied Case and Two Living Patients

“…The idea that variably acid‐fast, pleomorphic bacteria are associated with certain malignancies 20–27 (and also with certain collagen diseases 28,29 ) has been proposed by a number of different investigators. The histologic appearance of the coccoid forms purported to be microbes in this present report of cases of mycosis fungoides is strikingly similar to the histologic appearance of coccoid forms that have been reported to be associated with cancers of the breast, 27 Kaposi's sarcoma, 30 Hodgkin's disease, 31 lymphoma, 32 sarcoidosis, 33 scleroderma, 29 scleredema, 34 and hypodermitis sclerodermiformis 13,14 . In addition, there is increasing evidence which suggests that the blood of both diseased and “normal” individuals contains cell‐wall‐deficient forms of bacteria, 35–38 some of which may be acid‐fast 39 .…”

Infections Are Not Increased in Scleroderma Compared to Non-Inflammatory Musculoskeletal Disorders Prior to Disease Onset

“…Early case studies described SSc and acid-fast bacterial infections [ 6 - 8 ]. We could also postulate an altered immune system or unknown co-factor increasing the risk of both tuberculosis (TB) and SSc.…”