case_images: PMC8886172_01
case_images: A) Typical colony characteristics of
  Candida sp
  . on Sabouraud Dextrose Agar.. B) Positive germ tube formation in human serum confirmed the diagnosis of
  Candida albicans. C) Antifungal sensitivity assay on Mueller-Hinton agar for Fluconazole (Flu; 25 mug), Itraconazole (ITC; 8 mug), Nystatin (NY; 100 U), and Amphotericin B (AMB; 10 mug) showed strongest inhibition with Itraconazole.
case_images: f1000research-10-55742-g0000.jpg
case_images: PMC8886172_01_f1000research-10-55742-g0000.jpg
case_images: f1
case_images: Sabouraud Dextrose Agar at 37  C for 24 hours revealed Candida sp . colonies. Subculturing, to ensure purity and optimal growth, with chloramphenicol, confirmed the presence of large white, round, curved, soft and smooth to wrinkle colonies with a characteristic yeast odor ( Figure 1A). Examination of air-dried fixed smears stained with Gram's stain under a light microscope using 100x oil immersion objective showed gram positive budding yeast cells indicative of Candida albicans that was confirmed by positive germ tube formation by germ tube test ( Figure 1B). After 3-5 minutes, the antifungal disks for Fluconazole (25 mug), Itraconazole (8 mug), Nystatin (100 U), and Amphotericin B (10 mug) were applied with gentle pressure (Rev.7/03.12.2012; Liofilchem   S.r.l., Italy). After 24 hours of aerobic incubation at 35  C, the diameter of the growth inhibition zone was manually measured for comparison of the antifungal sensitivity that turned highest with Itraconazole followed by Nystatin, Amphotericin B then the least effective was Fluconazole ( Figure 1C).  