Hyalohyphomycete or zygomycete? Challenges with microscopic diagnosis
نویسندگان
چکیده
Background: Invasive mould infections are associated with profound morbidity. Direct microscopic examination of specimens is a useful tool for laboratories to advise clinicians on the presumptive identity. Nonetheless, pitfalls abound. Here, we highlight how microscopy may not always be straightforward. Case description: A 69-year-old male T cell lymphoma was admitted chemotherapy. Shortly after conditioning, he developed hand cellulitis which progressed 10 cm necrotic ulcer despite vancomycin and piperacillin-tazobactam. Skin biopsy performed. Gram stain calcofluor white revealed narrow hyphae suggestion septa 45 degree branching. Given clinical syndrome (eschar in an immunocompromised host), communicated our suspicion Fusarium clinician, who started voriconazole. Overnight, cottony grew. Lactophenol cotton blue irregular, broad, ribbon-like sporangia. The clinician informed possibility Mucorales. Antifungals were switched liposomal amphotericin B. Internal transcribed spacer sequencing subsequently confirmed as Rhizopus arrhizus. Antifungal susceptibility testing MICs 1 μg/ml >8 B voriconazole respectively. Discussion: findings should correlated colonial morphology. Clinicians promptly critical so appropriate treatment can instituted.
منابع مشابه
Primary Umbilical Endometriosis: Unusual Clinical Presentation with microscopic diagnosis.
INTRODUCTION: Endometriosis, commonly occurs in the pelvic organs, mostly the ovaries, with dysmenorrhea, menorrhagia Umbilical endometriosis is rare .Symptoms include umbilical masses with swelling and pain.. SO it is often not recognized based on its clinical appearance. PRESENTATION OF CASE: A 32-year old female, was presented with umbilical bulging and mild cyclic umblical pain. with...
متن کاملIran and Central Asia: Chances or Challenges?
The fall of Soviet Union and independence of republics of central Asia as well as South Caucasus have brought both chances and challenges for Iran. At first it seemed that Muslim republics, which broke from Soviet Union, might have brought great chances for Iran to promote her ideological claims and economic interests. Dreams of Islamic revolution in new independent central Asian republics invo...
متن کاملMicroscopic colitis: a missed diagnosis?
CONTEXT Collagenous colitis and lymphocytic colitis, collectively designated microscopic colitis, have until recently been considered as rare gastrointestinal disorders. New data suggest, however, that these disorders are relatively common, and to reach the correct diagnosis both the gastroenterologist and the pathologist must be aware of these diagnoses when evaluating patients with persistent...
متن کاملBreast Cancer or a Rear Diagnosis
Introduction: Tuberculosis (TB) and its diagnosis are of great importance in the middleeast, according to the increasing burden of this disease and the large number of unreported cases. Less than 20% of all TB cases only have extra-pulmonary manifestations and breast TB is a rare form of extra-pulmonary TB. It includes about 1% of all breast lesions. Case Presentation: This study presents a br...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Pathology
سال: 2023
ISSN: ['1465-3931', '0031-3025']
DOI: https://doi.org/10.1016/j.pathol.2022.12.144