The ear in the acquired immunodeficiency syndrome: I. Temporal bone histopathologic study

Area of Science:

• Otolaryngology
• Infectious Diseases
• Pathology

Background:

• The acquired immunodeficiency syndrome (AIDS) affects multiple organ systems.
• The susceptibility of the ear to AIDS-associated diseases, particularly opportunistic infections, requires detailed investigation.

Purpose of the Study:

• To investigate the histopathologic changes in the temporal bones of patients with acquired immunodeficiency syndrome (AIDS).
• To determine the prevalence of specific pathologies, including otitis media and opportunistic infections like cytomegalovirus (CMV), within the temporal bones of AIDS patients.

Main Methods:

• Postmortem histopathologic examination of temporal bones from 25 AIDS patients (49 temporal bones total).
• Techniques included microslicing, acid decalcification, and paraffin embedding.
• In situ hybridization and immunohistochemistry were used to detect cytomegalovirus (CMV).

Main Results:

• Otitis media was prevalent, with severe forms in 20% and low-grade in 60% of patients.
• Opportunistic infections were observed, including labyrinthine cryptococcosis (2 patients), Kaposi's sarcoma (1 patient), and cytomegalovirus (CMV) inclusion-bearing cells (6 patients).
• CMV genome detection was limited by decalcification methods, with successful identification in only two bones.

Conclusions:

• The temporal bone is significantly affected by AIDS-associated pathologies, comparable to other organs.
• Cytomegalovirus (CMV) infection is a notable opportunistic pathogen in the auditory system of AIDS patients.
• Standard histopathologic techniques may be affected by decalcification processes when detecting viral elements.