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Step I Nocardia causing caseating granuloma
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Nocardia, systemic fungi, and mycobacterial infections are the big three.
From UpToDate (Clinical manifestations and diagnosis of nocardiosis):
"Histopathology — Histopathology of tissue specimens most often shows necrosis [72-74] with abscess (including microabscess) formation. There may be a mixed cellular infiltrate of polymorphonuclear leucocytes [73,75], lymphocytes [73,75], plasma cells [75,76], and hemosiderin-laden macrophages [75,76]. Granulomas with central necrosis mimicking tuberculosis have been described in lung and pleural tissue [73,77], but these findings occur infrequently [75]. Organisms can sometimes be seen on histologic stains, including methenamine silver and the Grocott stain [72,74,77]."
I bolded that sentence. But that's a direct quote from UTD.
Hope the helps,
From UpToDate (Clinical manifestations and diagnosis of nocardiosis):
"Histopathology — Histopathology of tissue specimens most often shows necrosis [72-74] with abscess (including microabscess) formation. There may be a mixed cellular infiltrate of polymorphonuclear leucocytes [73,75], lymphocytes [73,75], plasma cells [75,76], and hemosiderin-laden macrophages [75,76]. Granulomas with central necrosis mimicking tuberculosis have been described in lung and pleural tissue [73,77], but these findings occur infrequently [75]. Organisms can sometimes be seen on histologic stains, including methenamine silver and the Grocott stain [72,74,77]."
I bolded that sentence. But that's a direct quote from UTD.
Hope the helps,
