title: Pathology of infectious diseases: what does the future hold?
abstract: The demand for expertise in pathology for the diagnosis of infectious diseases (ID) is continually growing, due to an increase in ID in immunocompromised patients and in the (re)-emergence of common and uncommon diseases, including tropical infections and infections with newly identified microbes. The microbiology laboratory plays a crucial role in diagnosing infections, identifying the responsible infectious agents and establishing sensitivity of pathogens to drug therapy. Pathology, however, is the only way to correlate the presence of an infectious agent with the reaction it evokes at cell and tissue level. For pathologists working in the field of ID pathology, it is essential to dispose of competence in cell and tissue pathology as well as in microbiology. Expertise in ID includes understanding of taxonomy and classification of pathogens as well as morphological criteria supporting their identification. Moreover, ID pathologists must master the methods used to detect pathogens in fixed cell and tissue samples, notably immunohistochemistry, in situ hybridization and the polymerase chain reaction. Paradoxically, the increasing frequency of lesions caused by pathogens and diagnosed in a pathology laboratory appears to be paralleled by a gradual loss of expertise of pathologists in the field of infectious and tropical diseases. We contend that this may be due at least in part to the continuously increasing number of samples of tumor tissue pathologists deal with and the rapidly expanding number of tissue based biomarkers with predictive value for new anti-cancer therapies. In this review, we highlight current and future issues pertaining to ID pathology, in order to increase awareness of its importance for surgical and molecular pathology. The intention is to contribute to the development of best practice in ID pathology.
authors.affiliation: Laboratory of Clinical and Experimental Pathology (LPCE), Hôpital Pasteur, BP 69, Centre Hospitalo-Universitaire, 06002, Nice, France. hofman.p@chu-nice.fr.|Pasteur Hospital Biobank (BB-0033-00025), Pasteur Hospital, Nice, France. hofman.p@chu-nice.fr.|FHU OncoAge, University of Nice Côte d'Azur, Nice, France. hofman.p@chu-nice.fr.
authors.forename: Paul
authors.initials: P
authors.lastname: Hofman
authors.affiliation: Department of Histopathology, King's College London School of Medicine, St Thomas' Hospital, London, UK.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lucas
authors.affiliation: Institut Pasteur, Human Histopathology and Animal Models Unit, Infection and Epidemiology and Paris Descartes University, ED Bio, Sorbonne Paris Cité, Paris, France.
authors.forename: Grégory
authors.initials: G
authors.lastname: Jouvion
authors.affiliation: Centre Hospitalier Sainte-Anne, Neuropathology Laboratory, Paris, France.
authors.forename: Arnault
authors.initials: A
authors.lastname: Tauziède-Espariat
authors.affiliation: Institut Pasteur, Human Histopathology and Animal Models Unit, Infection and Epidemiology and Paris Descartes University, ED Bio, Sorbonne Paris Cité, Paris, France.|Centre Hospitalier Sainte-Anne, Neuropathology Laboratory, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Chrétien
authors.affiliation: Institut fur Pathologie, Kantonsspital, Baselland, Liestal, Switzerland.
authors.forename: Gieri
authors.initials: G
authors.lastname: Cathomas
mesh_terms: D006801:Humans; D055552:Infectious Disease Medicine / Q000639:trends*; D010338:Pathology, Clinical / Q000639:trends*; D011361:Professional Competence
keywords: Ancillary methods; Expertise; Infectious disease pathology; Subspecialty; Tropical disease pathology