Bacterial co-infections detected with histopathology, special stains, and IHC. A, D, and G: H&E staining; B, E, and H: immunoalkaline phosphate staining, naphthol fast red substrate with light hematoxylin counterstain; C and F: Lilly-Twort tissue Gram staining. Original magnification: ×25 (A, D, and G); ×100 (B and E); ×158 (C and F); ×50 (H). A: Abundant neutrophilic infiltrate in the alveoli indicative of an acute pneumonic process. B: Extracellular and intracellular immunostaining of S. pneumoniae antigens. C: Gram-positive cocci in the serial section as B. D: Abundant neutrophilic infiltrate in the alveoli of another patient with pneumonia. E: Extracellular and intracellular immunostaining of Group A Streptococcus antigens. F: Gram-positive cocci in the serial section as E. G: Prominent necrosis and neutrophilic infiltrate indicative of a necrotizing pneumonia. H: Abundant immunostaining of S. aureus.