Microbiology Case Study: 76 Year Old Female with Upper Back Pain

Lablogatory

Case History:
A 76 year old female presents with a two year history of worsening upper back pain. Imaging revealed compression fractures of the first three thoracic vertebrae (T1-T3). Fine needle aspiration and a core biopsy of the T3 vertebral body were examined in surgical pathology. There was acute and chronic granulomatous inflammation with fungal organisms observed on histologic examination. Surgery for decompression and fusion of C5-T6 vertebrae was performed and tissue was sent for fungal culture.

Potato flake agar shows a tan-brown fungus. Potato flake agar shows a tan-brown fungus.

Mycosel agar shows beige-white fungal growth. Mycosel agar shows beige-white fungal growth.

Scotch tape prep shows septate hyphae with unbranched conidiophores and single, terminal, "lollipop" conidia. Scotch tape prep shows septate hyphae with unbranched conidiophores and single, terminal, “lollipop” conidia.

Silver stain of involved bone with fungal organisms exhibiting broad-based budding. Silver stain of involved bone with fungal organisms exhibiting broad-based budding.

Laboratory Identification:
The workup revealed a thermally dimorphic fungus with a mold form growing in the laboratory at 25°C and a yeast form present in the surgical pathology specimen. The mold form is moderately slow…

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