Comparison between organismal staining on histology and tissue culture in the diagnosis of cutaneous infection: A retrospective study.
J Am Acad Dermatol
; 82(6): 1400-1408, 2020 Jun.
Article
em En
| MEDLINE
| ID: mdl-32004643
ABSTRACT
BACKGROUND:
In instances of suspected cutaneous infection, the standard of care includes obtaining skin biopsy specimens for histology and tissue culture. Few studies have compared the clinical utility of each test.OBJECTIVE:
To assess the concordance of results between tissue culture and histology, as well as the clinicopathologic features that may influence the diagnostic yield of each test.METHODS:
A retrospective review of all patients who underwent skin biopsy for histology and tissue culture at New York University from 2013 through 2018.RESULTS:
Of 179 patients, 10% had positive concordance, 21% had positive tissue culture only, and 7% had positive histology only. We calculated a kappa correlation coefficient of 0.25 between histology and tissue culture (reference, 0.21-0.39 indicates minimal agreement). Histology exhibited higher sensitivity in detecting fungi, whereas tissue culture was more sensitive in identifying Gram-negative bacteria. Antimicrobial use before biopsy led to significantly fewer positive cultures (37.5% vs 71%; P = .023) in patients ultimately diagnosed with infection.LIMITATIONS:
This study was conducted at a single institution, thereby restricting its broad applicability. The lack of a validated criterion standard to diagnose infection also limits interpretation of the results.CONCLUSION:
Tissue culture and histopathology often yield discordant results. Dermatologists should recognize specific limitations, yet high clinical utility in special circumstances, of tests when approaching cases of suspected infection.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Dermatopatias Infecciosas
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article