Microscopic Observation
Table of Contents
- The structure appears as a refractile, branching filamentous form.
- It shows septate hyphae with branching at acute angles.
- Some segments appear slightly swollen or beaded, suggesting possible pseudohyphal elements or early germination.
Interpretation
The structure is highly suggestive of fungal elements, most likely:
Septate fungal hyphae
- Consistent with Aspergillus species or Candida (pseudohyphae) if present with blastoconidia.
- In an immunocompromised patient, this could represent invasive fungal infection.
Key Differential Diagnoses
| Finding | Possible Organism |
|---|---|
| Septate hyphae, acute angle branching | Aspergillus spp. |
| Pseudohyphae with budding | Candida spp. |
| Broad, ribbon-like, non-septate | Mucorales (less likely here) |
Recommended Follow-Up
- Perform Lactophenol Cotton Blue (LPCB) prep from culture for definitive ID.
- Consider Gomori Methenamine Silver (GMS) or PAS stain on biopsy if tissue is available.
- Culture on Sabouraud Dextrose Agar (SDA) with and without cycloheximide.
- Consider the Galactomannan assay or Beta-D-glucan if Aspergillosis is suspected.
Conclusion
This is a fungal element consistent with septate hyphae, likely Aspergillus or Candida pseudohyphae. In the context of a cancer patient, this warrants clinical correlation and prompt antifungal evaluation.
Further Readings
- Medical Mycology. Editors: Emmons and Binford, 2nd ed 1970, Publisher Lea and Febiger, Philadelphia.
- Rippon’s JW: Medical Microbiology. The pathogenic fungi and the Pathogenic Actinomycetes. 3rd ed 1988 Publisher WB Saunder co, Philadelphia.
- Clinical Microbiology Procedure Handbook, Chief in editor H.D. Isenberg, Albert Einstein College of Medicine, New York, Publisher ASM (American Society for Microbiology), Washington DC.
- A Textbook of Medical Mycology. Editor: Jagdish Chander. Publication Mehata, India.
- Practical Laboratory Mycology. Editors: Koneman E.W. and G.D. Roberts, 3rd ed 1985, Publisher Williams and Wilkins, Baltimore.
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