case_images: PMC9260090_01
case_images: (a) Dry and rough black or olive black colonies upon maturation - note the dry edges as the colonies mature. (b) Lactophenol blue stain shows Exophiala dermatitidis conidia.
case_images: acmi-4-0347-g001.jpg
case_images: PMC9260090_01_acmi-4-0347-g001.jpg
case_images: F1
case_images: Dickinson, Sparks, MD, USA) from both catheter tip and blood culture, the initial creamy colonies transitioned to be dry and black olive in colour with maturation (Fig. 1a), and non-Candida yeast or mould was suspected. Direct microscopic examination of the organism showed oval budding yeasts cells, and lactophenol blue staining of the mature colonies revealed pigmented septate branched hyphae with annelidic conidiogenesis, and ellipsoidal conidia of different sizes with a thin wall, forming aggregates (Fig. 1b) that were consistent with Exophiala species.
case_images: PMC9260090_02
case_images: The acid-fast 
  
  Mycobacterium canariasense
  
   appearing yellow or green when stained with auramine-rhodamine stain.
case_images: acmi-4-0347-g002.jpg
case_images: PMC9260090_02_acmi-4-0347-g002.jpg
case_images: F2
case_images: The initial auramine-rhodamine stain performed from the blood culture was positive for the acid-fast organism (Fig. 2), but the specimen inoculated into Lowenstein-Jensen medium and a protein-rich medium, Middlebrook medium 7H10 (Becton Dickinson, Sparks, MD, USA), incubated at 37  C showed no growth, and specimens were sent to the reference laboratory for identification.
case_images: PMC9260090_03