Infectious Pancreatitis

 Should be considered in immunocompromised patients with pancreatitis


image Pancreatic involvement is usually mild in cases of systemic infection


• Acute infection of pancreas is usually secondary event
image Occurs in 40-70% of patients with necrotizing pancreatitis

image Usually due to gram-negative aerobic bacteria
– May also be caused by fungal infection, typically Candida




Etiology/Pathogenesis




• Many different viruses, parasites, bacteria, and fungi
image Viruses

– Mumps, coxsackievirus, CMV

image Mumps can cause severe pancreatitis

image Bacteria

– Many different pathogens, typically gram negative ( Escherichia coli )

image Fungi

– Candida species most common

image Parasites

– Ascaris, Clonorchis, Toxoplasma

• Many cases associated with immune compromise


Clinical Issues




• Presentation, treatment, prognosis depend on specific infection and clinical scenario


Microscopic




• Gross and histologic findings are not well described

image
CMV
CMV infection of the pancreas is most often seen in immunocompromised patients, especially AIDS patients.


image
Ascaris
Ascaris lumbricoides can migrate into the pancreatic duct, causing an obstructive pancreatitis.

image
Echinococcus
Acute pancreatitis can follow rupture of a hepatic hydatid cyst into the bile ducts with secondary obstruction of the pancreatic ducts. Rarely, Echinococcus causes primary pancreatic infection.

image
Candida
Candida infection is the most common fungal infection complicating acute pancreatitis.


TERMINOLOGY


Definitions




• Acute infection of pancreas is usually secondary event
image Occurs in 40-70% of patients with necrotizing pancreatitis

image Usually due to gram-negative aerobic bacteria

image Fungi (typically Candida ) may also superinfect acute pancreatitis

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Apr 20, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Infectious Pancreatitis

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