Burnham, Carey-Ann D

Dunne, W. Michael, Jr.

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Washington University School of MedicineDigital Commons@BeckerOpen Access Publications2011Photo Quiz: A 32-year-old male with a 2-monthhistory of cough, fatigue, and weight lossCarey-Ann D. BurnhamWashington University School of Medicine in St. LouisW. Michael Dunne Jr.Washington University School of Medicine in St. LouisFollow this and additional works at: http://digitalcommons.wustl.edu/open_access_pubsThis Open Access Publication is brought to you for free and open access by Digital Commons@Becker. It has been accepted for inclusion in OpenAccess Publications by an authorized administrator of Digital Commons@Becker. For more information, please contact engeszer@wustl.edu.Recommended CitationBurnham, Carey-Ann D. and Dunne, W. Michael Jr., ,"Photo Quiz: A 32-year-old male with a 2-month history of cough, fatigue, andweight loss." Journal of Clinical Microbiology.49,10. 3499. (2011).http://digitalcommons.wustl.edu/open_access_pubs/2350  10.1128/JCM.01126-11. 2011, 49(10):3449. DOI:J. Clin. Microbiol. Carey-Ann D. Burnham and William Michael Dunne Jr. of Cough, Fatigue, and Weight LossA 32-Year-Old Male with a 2-Month Historyhttp://jcm.asm.org/content/49/10/3449Updated information and services can be found at: These include:CONTENT ALERTS more»articles cite this article), Receive: RSS Feeds, eTOCs, free email alerts (when newhttp://journals.asm.org/site/misc/reprints.xhtmlInformation about commercial reprint orders: http://journals.asm.org/site/subscriptions/To subscribe to to another ASM Journal go to:  on March 8, 2014 by Washington University in St. Louishttp://jcm.asm.org/Downloaded from  on March 8, 2014 by Washington University in St. Louishttp://jcm.asm.org/Downloaded from JOURNAL OF CLINICAL MICROBIOLOGY, Oct. 2011, p. 3449 Vol. 49, No. 100095-1137/11/$12.00 doi:10.1128/JCM.01126-11Copyright © 2011, American Society for Microbiology. All Rights Reserved.Photo Quiz(For answer and discussion, see page 3726 in this issue [doi:10.1128/JCM.r01126-11])A 32-Year-Old Male with a 2-Month History of Cough, Fatigue, and Weight LossA 32-year-old male presented with a 2-month history ofproductive cough (no hemoptysis), fatigue, and weight loss (10lbs). He had a good appetite but became nauseated wheneating, and with early satiety. He had been experiencing chillsand fevers for approximately 1 month and also had a red,raised lesion on his nose. Two weeks prior to presentation, hehad taken a 5-day course of oral azithromycin with no relief.The man was born in Vietnam but had lived in the UnitedStates for the past 12 years. He was unmarried and lived withhis family, was employed as an industrial worker, and deniedhaving had sexual activity during the past 5 years. He deniedhaving used alcohol, tobacco, or drugs.Numerous laboratory and imaging studies were performed,including a chest computed tomography (CT) revealing pul-monary nodules and medastinal and right hilar lyphadopathy.Blood cultures drawn on admission (VersaTREK REDOX1[aerobic bottles]) (TREK Diagnostic Systems, Cleveland, OH)became positive after 2 days of incubation with fungal elements(delicate, septate hyphae). After approximately 4 to 5 days ofincubation on solid medium, growth of a fungus with a diffus-ible red pigment was noted (Fig. 1).Carey-Ann D. Burnham*Departments of Pediatrics and Pathology & ImmunologyWashington University School of Medicine660 S. Euclid AveCampus Box 8118St. Louis, Missouri 63110William Michael Dunne, Jr.Department of Pathology & ImmunologyWashington University School of MedicineSt. Louis, Missouri 63110*Phone: (314) 362-1547Fax: (314) 454-2274E-mail: cburnham@path.wustl.eduFig. 1. Colonial morphology of the organism grown on Sabouraud dextrose agar.3449 on March 8, 2014 by Washington University in St. Louishttp://jcm.asm.org/Downloaded from 

Photo Quiz: A 32-year-old male with a 2-month history of cough, fatigue, and weight loss

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Photo Quiz: A 32-year-old male with a 2-month history of cough, fatigue, and weight loss

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