Mucocutaneous Splendore‐Hoeppli phenomenon

Abstract

Splendore-Hoeppli phenomenon (asteroid bodies) is the in vivo formation of intensely eosinophilic material (radiate, star-like, asteroid or club-shaped configurations) around microorganisms (fungi, bacteria and parasites) or biologically inert substances. This study presents a literature review concerning Splendore-Hoeppli reaction in the mucocutaneous diseases. It examines the histopathological features, nature and differential diagnosis of this reaction. It also discusses the mucocutaneous infections and the non-infective diseases associated with it. Available studies indicate that several mucocutaneous infections can generate Splendore-Hoeppli reaction. The fungal infections include sporotrichosis, pityrosporum folliculitis, zygomycosis, candidiasis, aspergillosis and blastomycosis. The bacterial infections include botryomycosis, nocardiosis and actinomycosis. The parasitic conditions include orbital pythiosis, strongyloidiasis, schistosomiasis and cutaneous larva migrans. In addition, Splendore-Hoeppli reaction may be seen with non-infective pathology such as hypereosinophilic syndrome and allergic conjunctival granulomas. The Splendore-Hoeppli reaction material comprises antigen-antibody complex, tissue debris and fibrin. Although the exact nature of this reaction is unknown, it is thought to be a localized immunological response to an antigen-antibody precipitate related to fungi, parasites, bacteria or inert materials. The characteristic formation of the peribacterial or perifungal Splendore-Hoeppli reaction probably prevents phagocytosis and intracellular killing of the insulting agent leading to chronicity of infection. To conclude, Splendore-Hoeppli reaction is a tell tale of a spectrum of infections and reactive conditions. The molecular pathways involved in the development of this reaction are open for future investigations.

Atypical actinobacillosis in bulls in Argentina: granulomatous dermatitis and lymphadenitis

“…The histopathological changes observed in the skin biopsy from the affected bull, were similar to the described in previous reports. Lesions of actinobacillosis have a very distinctive pattern, reported as Actinobacillus granulomas, which consist of neutrophils and club-like rosettes with a central mass of Gram negative bacilli (Splendore hoepli) surrounded by neutrophils, mononuclear cells and fibrosis (Anderson et al 1990, Aslani et al 1995, Rycroft & Garside 2000, Milne et al 2001, Radostits et al 2007, Hussein 2008, Angelo et al 2009, Taghipour Bazargani et al 2010.…”

Histological Study of Bovine Nocardial Eosinophilic Granuloma with Comparison of Splendore-Hoeppli Material

“…Similar eosinophilic granulomas have been caused by C. ulcerans T. Oyama et al (Murakami et al 2014) and M. granulomatis (Riet-Correa et al 1992), and further studies would find other organisms associated with bovine eosinophilic granuloma. Splendore-Hoeppli material is said to consist of tissue debris, fibrin, and immunoglobulin (Hussein 2008, Johnson et al 2010. In two cases of human conjunctival lesions exhibiting the Splendore-Hoeppli phenomenon, one revealed predominantly immunoglobulin deposition, whereas the other revealed primarily eosinophilic major basic protein (Read et al 2005).…”

“…The Splendore-Hoeppli phenomenon is seen by hematoxylin and eosin (HE) staining as club-shaped or band-like eosinophilic structures surrounding microorganisms or foreign bodies (Hussein 2008, Schnadig 2010. Bacterial colonies with surrounding Splendore-Hoeppli material are designated sulfur granules, which may be observed in infections of Actinomyces, Trueperella pyogenes, Actinobacillus, Staphylococcus aureus, and Pseudomonas aeruginosa in cattle (Kubo et al 1980(Kubo et al , 1981(Kubo et al , 1982.…”

New Diagnostic Applications in Sporotrichosis

“…Several authors observed the Splendore-Hoeppli reaction on histopathologic tissue sections from sporotrichosis patients. This reaction indicates a localised immunologic response to antigens of several infectious organisms, such as fungi, bacteria and parasites (Hussein, 2008), and appears as a radiating homogenous, refractile, eosinophilic, club-like material surrounding a central eosinophilic focus (Larone, 2002). Splendore first observed this structure in 1908 on tissue sections from patients with sporotrichosis and afterwards by Hoeppli in 1932 around schistosome larvae (Kwon-Chung & Bennett, 1992).…”