Some fungus-like materials were found in the deep dermal inflammation tissue from a 76-year-old lady's right hand. She presented with soft tissue swelling with redness on her right hand after antibiotic treatment failure. She said she has high blood sugar when she tested herself with a blood glucose test kit. But she was not properly diagnosed or treated for that.
What kind of fungus should I include in the differential diagnosis?
(phaeohyphomycosis?) Is this definitely fungal infection? if not, what this would be?
Any ideas are welcome!
Attached pics are PAS stained slide taken at x1K
Dear Yosep,
Not because I work on protist pathogens, but to me looks like trophozoites of some amoeba. Try to grow the swab assisted wound material on sabouraud's medium to rule out fungus. Could be Acanthamoebal trophozoites, deep eosinophilic cells??
Best,
Mannan
Hello, Dr. Chong, to me these don't look fungal organisms. Do GMS to prove these are fungi first. PAS is not specific to detect fungi. Did this patient have any trauma history to bring foreign materials (such as thorn, tooth pick, etc) to this inflamed area. Have a nice day! Jae Ro, MD
Hi, in general diagnosis with all features infection it is candidiasis
Hello, remake the levy is make a culture on medium sabouraud. Examination shows yeasts of small size: Histoplasma, Cryptococcus, Sporthrix, ...
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