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Image Quiz

2017 May

<p>A woman in her fifties with glioblastoma, on treatment with vancomycin via a percutanously inserted central catheter (PICC) for a Staphylococcal surgical site scalp infection, presented with fevers and chills. Blood cultures drawn on the day of presentation became positive 5 days later. Gram and Calcofluor white stains of the blood culture broth showed yeast-like forms. Two days later, scant growth of a dark flat colony was noted on Sabouraud Dextrose agar (Figure 1). A lactophenol cotton blue stain of the colony showed yeast-like cells (Figure 2). Two weeks later, the colony was stained again, showing brown septated hyphae.</p>

A woman in her fifties with glioblastoma, on treatment with vancomycin via a percutanously inserted central catheter (PICC) for a Staphylococcal surgical site scalp infection, presented with fevers and chills. Blood cultures drawn on the day of presentation became positive 5 days later. Gram and Calcofluor white stains of the blood culture broth showed yeast-like forms. Two days later, scant growth of a dark flat colony was noted on Sabouraud Dextrose agar (Figure 1). A lactophenol cotton blue stain of the colony showed yeast-like cells (Figure 2). Two weeks later, the colony was stained again, showing brown septated hyphae.

The most likely diagnosis is which of the following?



What is the diagnosis?
  • Candida glabrata
  • Cryptococcus neoformans
  • Aspergillus fumigatus
  • Histoplasma capsulatum
  • Exophiala dermatitidis
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