Qap (Anatomical Pathology) 

QAP Peer Review

AP231
Case History: M/44 Known HIV infection. Newly diagnosed acute promyelocytic leukemia on chemotherapy. Sacral skin ulcer.
Intended diagnosis: Herpes infection. Contributed by:JKCC
Code Diagnosis Comment Score
anonymous Herpes simplex viral infection (100%) nil  100
anonymous HSV infection nil  100
anonymous Herpes, favour Varicella-Zoster virus nil  100
anonymous Herpes infection Confirm by immunostaining for herpes simplex virus  100
anonymous HERPES INFECTION and SUSPICIOUS OF MYCOBACTERIUM AVIUM- INTRACELLULARE. 100% Confirm herpes by immunostain and MAI by ZN stain. Other infective agents to be excluded are atypical TB by ZN stain, leprosy by Wade Fite stain, and fungi by grocott stain. To correlate with culture. Also to exclude leukemic infiltration by CAE and myeloperoxidase in some large atypical white cells.  90
anonymous Herpesvirus infection.(100%) Do herpesvirus stain.  100
anonymous Herpes infection 30% Leukemia cutis 30% Acute febrile neutrophilic dermatosis (Sweet's syndrome) 40% a)Degenerated keratinocytes with multinucleation and ground nuclei - suggestive of Herpes infection. Other infectious causes need to be ruled out by special stains/culture. b)Atypical cells present, suspicious of immature granulocytes-Leukemic infiltration needs to be considered (CAE stain). c)Sweet's syndrome is known to be associated with AML.  60
anonymous Ulcer and Herpes Virus Infection nil  100
anonymous SKIN, sacral ulcer : Herpetic ulcer. 100%. nil  100
anonymous Herpes simplex viral infection with ulceration. nil  100
anonymous SKIN, sacral, biopsy - HERPES INFECTION. nil  100
anonymous Herpes infection Perform Ziehl-Neelsen and fungal stains to exclude concomitant infections.  100
anonymous Herpes viral infection (100%) nil  100
anonymous Herpes infection. 100% Probability nil  100
anonymous Herpes viral infection 100% Perform special stains for microorganisms to exclude other infections.  100
anonymous Herpes infection nil  100