case_images: PMC8742591_01
case_images: (a) Tissue culture showing growth of flat, off-white to cream, dry and finely suede-like colonies after 24 h of incubation on Sabouraud dextrose agar. (b) Lactophenol cotton blue stain microscopy at 1000x magnification showing hyaline, septate hyphae which break up into chains of hyaline, smooth, one-celled arthroconidia.
case_images: acmi-3-0287-g001.jpg
case_images: PMC8742591_01_acmi-3-0287-g001.jpg
case_images: F1
case_images: The culture of the tissue (Fig. 1a) showed growth of flat, off-white to cream, dry and finely suede-like colonies after 24 h of incubation at 25  C on Sabouraud dextrose agar. Lactophenol cotton blue stain (Fig. 1b) revealed hyaline, septate hyphae that break up into chains of hyaline, smooth, one-celled arthroconidia.
case_images: (a) Hematoxylin and eosin stain microscopy of tissue biopsy at 400x magnification showing a granuloma with central neutrophilic micro-abscess formation. (b) Periodic acid-Schiff stain microscopy of tissue biopsy at 400x magnification highlighting arthroconidia. (c) Grocott-Gomori's silver stain microscopy of tissue biopsy at 400x magnification showing fungal elements.
case_images: acmi-3-0287-g002.jpg
case_images: PMC8742591_01_acmi-3-0287-g002.jpg
case_images: F2
case_images: Some of the granulomas (Fig. 2a) show central neutrophilic micro-abscess formation. The presence of fungal hyphae is noted (Fig. 2a). Periodic acid Schiff (PAS) (Fig. 2b) and Grocott-Gomori's Methenamine Silver (Fig. 2c) stains highlighted the arthroconidia.
case_images: PMC8742591_02
case_images: Timeline of events shown in weeks since first presentation of patient.
case_images: acmi-3-0287-g003.jpg
case_images: PMC8742591_02_acmi-3-0287-g003.jpg
case_images: F3
case_images: Refer to Fig. 3 for the timeline.