case_images: PMC3808793_01
case_images: High-power PAS stain shows a glomerulus infiltrated by fungal hyphae. x40.
case_images: cru-0003-0058-g01.jpg
case_images: PMC3808793_01_cru-0003-0058-g01.jpg
case_images: F1
case_images: There was a focal cortical infarct accounting for approximately 10% of the overall biopsy, with focal small vessels containing fungal hyphae (fig. 1).
case_images: a Gross pathology specimen with a large cortical infarct. b Cut specimen with a large cortical infarct.
case_images: cru-0003-0058-g02.jpg
case_images: PMC3808793_01_cru-0003-0058-g02.jpg
case_images: F2
case_images: A pathology exam performed after the nephrectomy (fig. 2a, b) showed significant cortical infarction involving more than half of the cortex, with patchy, widespread involvement of fungal hyphae that involved the ureteral lumen, ureteral wall, renal parenchyma and numerous large and small vessels.
case_images: Chest CT shows a 4.9 x 2.8-cm mass with cavitation within the posterior aspect of the right upper lobe and a moderate-sized area of consolidation involving the left lower lobe.
case_images: cru-0003-0058-g03.jpg
case_images: PMC3808793_01_cru-0003-0058-g03.jpg
case_images: F3
case_images: Chest CT showed a large right upper lobe cavitating mass measuring 4.9 x 2.8 cm, with scattered areas of smaller nodules present throughout both lungs (fig. 3).
case_images: Head CT reveals cortical hypoattenuation (arrows) within the bilateral frontal and occipital lobes with no peripheral enhancing.
case_images: cru-0003-0058-g04.jpg
case_images: PMC3808793_01_cru-0003-0058-g04.jpg
case_images: F4
case_images: This revealed interval development of areas of subcortical hypoattenuation involving the bilateral frontal lobes, bilateral occipital lobes and bilateral cerebral hemispheres, suggesting multifocal cerebritis with no abscesses (fig. 4).