Comparison between organismal staining on histology and tissue culture in the diagnosis of cutaneous infection: A retrospective study

The diagnostic accuracy of Gram stain on formalin‐fixed paraffin‐embedded sections of skin tissue in the diagnosis of bacterial skin infection

“…We expect the findings of this study to have reasonable generalizability to routine dermatological practice and were interested to note that the results of this study were similar to those reported in an earlier series of 179 skin biopsy specimens, 7 but it is not clear whether GS‐FFPE test performance could be extrapolated to non‐skin tissue samples, and further study may be warranted to evaluate GS‐FFPE test performance in specimens from non‐sterile sources such as the respiratory or gastrointestinal tracts.…”

“…In stark contrast, an earlier publication reported a sensitivity of 100%, but this series of 110 lung biopsy specimens included just five cases positive for bacterial infection 6 . In a more recent and comprehensive review including 179 skin biopsy specimens, histopathological assessment with or without histochemical stains had a sensitivity of 0.38 and specificity of 0.96 7 . As a counterpoint, histopathological assessment and tissue culture have been reported to have an overall concordance of 76.1% 8 …”

“…6 In a more recent and comprehensive review including 179 skin biopsy specimens, histopathological assessment with or without histochemical stains had a sensitivity of 0.38 and specificity of 0.96. 7 As a counterpoint, histopathological assessment and tissue culture have been reported to have an overall concordance of 76.1%. 8 In the absence of robust evidence regarding Gram stain test performance in FFPE specimens, its utility and diagnostic accuracy in clinical practice are somewhat uncertain.…”

A Rapidly Enlarging Facial Abscess

“…This should include infectious stains and tissue cultures, because they may have differing sensitivities. 6 This patient's history of visiting a tuberculosis-endemic area raised concern for lupus vulgaris, a form of cutaneous tuberculosis affecting patients with intact cell-mediated immunity, that is characterized by red-brown papules that favor the face. Histology displays variable tuberculoid or sarcoidal granulomas, usually lacking suppuration or caseation necrosis.…”

“…Regardless, suppurative granulomas on histology require a search for infection before diagnosing PG and initiating systemic immunosuppression. This should include infectious stains and tissue cultures, because they may have differing sensitivities . This patient’s history of visiting a tuberculosis-endemic area raised concern for lupus vulgaris, a form of cutaneous tuberculosis affecting patients with intact cell-mediated immunity, that is characterized by red-brown papules that favor the face.…”