... of endocarditis. Transesophageal echocardiography has a high sensitivity for detecting valvular lesions in native valves, while transthoracic echocardiography is the technique of choice in prosthetic valve disease. The mortality rate of patients with infective endocarditis can approach 20 to 30 percent...

... . 11. Heymans   S , Eriksson   U , Lehtonen   J , Cooper   LT   Jr . The quest for new approaches in myocarditis and inflammatory cardiomyopathy . J Am Coll Cardiol   2016 ; 68 : 2348 - 64 . 12. Leone   O , Veinot   J , Angelini   A , et al . 2011 consensus statement...

.... (Courtesy of the CDC PHIL) Septicemic plague refers to the presence of the bacilli in the blood, and can occur with or without a bubo. Septicemic plague can also lead to secondary pneumonic plague. The mortality rate for septicemic plague approaches 90 to 100 percent. During septicemic plague...

... persistent anemia, a transient aplastic crisis, and, if acquired during pregnancy, fetal hydrops, miscarriage, and intrauterine fetal death ( 3 ). Epidemiology Parvovirus B19 is ubiquitous and has a worldwide prevalence. In children under 5 years of age, seroprevalence approaches 20 percent, whereas...

... limited sensitivity in cutaneous and mucocutaneous leishmaniasis, however, and a combination approach is recommended. Liver biopsy and splenic aspirate are of great value in diagnosing visceral leishmaniasis, but can be complicated by catastrophic intra-abdominal hemorrhage. Bone marrow aspiration...

... rituximab therapy ( 8 ). Since most panels to test CSF using multiplex polymerase chain reaction (PCR) do not include flaviviruses, metagenomics has been used in a few cases to detect the latter ( 9 , 10 ). Metagenomic pathogen identification is based on an unbiased approach, which amplifies the nucleic...

... intensive supportive care may be seen. Mortality in such patients, however, remains low. The mortality rate due to PcP in individuals with HIV ranges from 4 to 32 percent, while it approaches 50 percent in those with other causes of immune suppression ( 48 ). Lung radiologic imaging often reveals atypical...

... Pathol   1994 ; 25 : 169 - 74 . 37. Slavik   T , Lauwers   GY . Navigating the jungles of tropical infectious gastrointestinal pathology: a pattern-based approach to the endoscopic biopsy . Virchows Arch   2018 ; 472 : 135 - 47 . 38. Geboes   K . Inflammatory disorders...

... of 10 to 20 percent, although this can approach 50 percent in pregnant women. Mortality is also increased in children under 5 years of age and those with comorbidities such as human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS). At a clinical level, the nonspecific...

... for relapsing fevers are cross reactive with Lyme disease and syphilis, a two-tiered approach is recommended ( 20 ). The western blot technique is usually used to test for patient antibodies to specific B. burgdorferi proteins, although interpretation of the presence of IgM or IgG has to follow...

... or droplets (Russell bodies), which may occasionally approach the size of erythrocytes. As the disease becomes chronic, there may also be associated fibrosis. The spleen and liver are frequently enlarged, revealing congestion and histiocyte/Kupffer cell hyperplasia. Cardiac involvement typically manifests...

... , Steinert   M . Virulence properties of the Legionella pneumophila cell envelope . Front Microbiol   2011 ; 2 : 74 . 16. Cunha   B , Cunha   C . Legionnaire’s disease, a clinical diagnostic approach . Infect Dis Clin North Am   2017 ; 31 : 81 - 93 . 17. Sopena   N , Force   L...

... the jungles of tropical infectious gastrointestinal pathology: a pattern-based approach to the endoscopic biopsy . Virchows Arch   2018 ; 472 : 135 - 47 . 7. Kirk   MD , Pires   SM , Black   RE , et al . World Health Organization estimates of the global and regional disease burden of 22...

..., distinguishing features and diagnostic pitfalls . Adv Anat Pathol   2009 ; 16 : 365 - 82 . 15. Aung   PP , Mutyambizi   KK , Danialan   R , Ivan   D , Prieto   VG . Differential diagnosis of heavily pigmented melanocytic lesions: challenges and diagnostic approach . J Clin Pathol   2015...

... problematic cases a combined approach using immunohistochemistry for PRAME and cytogenetic or various molecular studies may be helpful. NEVOID MELANOMA Figure 17-10 NEVOID MELANOMA A: Silhouette of a raised papule with smooth surface suggesting a possible Miescher nevus. B: The tumor cells are diffusely...

... requires a multidisciplinary approach ( 2 , 26 , 27 ). Early and complete surgical excision is considered ( 28 ). Complete removal, however, is rarely feasible, especially for giant CMNs, where melanoma risk is also highest. Furthermore, removal of cutaneous CMN does not eliminate the risk of melanoma...

... in a patient with a special histologic subtype tumor, a scenario that may arise in older patients for whom this management approach is a consideration. Most specifically, secretory carcinoma is characterized by an ETV6::NTRK3 translocation, which can be identified using a FISH breakapart probe against...

... not be amenable to core needle biopsy, and there may be some patients for whom co-morbidities preclude this diagnostic approach. The imaging modalities used include stereotactic mammography, ultrasound imaging, and magnetic resonance imaging (MRI), with a preference for ultrasound guidance for masses, either...

...   W , ed. Preneoplasia of the breast: a new conceptual approach to proliferative breast disease . Munich : Elsevier ; 2006 : 2 - 27 . 18. Cariati   M , Purushotham   AD . Stem cells and breast cancer . Histopathology   2008 ; 52 : 99 - 107 . 19. Shackleton   M...