Emerging Infectious Disease ISSN: 1080-6059

Identification of Cause of Posttransplant Cachexia by PCR

Joelle Guitard

, Sophie Edouard, Hubert Lepidi, Christine Segonds, Marion Grare, Marie-Laure Ranty-Quintyn, Isabelle Rouquette, Olivier Cointault, Lionel Rostaing, Nassim Kamar, and Florence Fenollar

Author affiliations: Centre Hospitalier Universitaire Rangueil, Toulouse, France (J. Guitard, C. Segonds, M. Grare, M.-L. Ranty-Quintyn, I. Rouquette, O. Cointault, L. Rostaing, N. Kamar); Université Aix-Marseille, Marseille, France (S. Edouard, H. Lepidi, F. Fenollar); Pôle de Maladies Infectieuses, Marseille (S. Edouard, F. Fenollar); and Université Paul Sabatier, Toulouse (L. Rostaing, N. Kamar)

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Figure

Duodenal biopsy specimen from the patient with posttransplant cachexia. Ziehl–Neelsen acid staining of a patient biopsy specimen, showing partially reduced villous architecture at low magnification, with numerous Ziehl–Neelsen-positive macrophages within the lamina propria (A, original magnification ×50). High magnification clearly demonstrates mycobacteria as bacillary particles in the macrophage cytoplasm (B, original magnification ×400). C) Macrophages within the lamina propria are periodic a

Figure. . . Duodenal biopsy specimen from the patient with posttransplant cachexia. Ziehl–Neelsen acid staining of a patient biopsy specimen, showing partially reduced villous architecture at low magnification, with numerous Ziehl–Neelsen-positive macrophages within the lamina propria (A, original magnification ×50). High magnification clearly demonstrates mycobacteria as bacillary particles in the macrophage cytoplasm (B, original magnification ×400). C) Macrophages within the lamina propria are periodic acid-Schiff–positive, diastase-resistant particles but do not show a morphologic granular pattern (original magnification ×200). D) Immunohistochemical staining with a polyclonal rabbit antibody against Tropheryma whipplei shows low immunostaining without a granular pattern (antibody used at a dilution of 1:2,000, hemalun counterstain, original magnification ×100).

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