Which stain binds to chitin and cellulose in the fungal cell wall and gives better visualization than 10% KOH? Under florescent microscope fungal elements appear bright apple

  green.

A 65-year-old woman with end-stage renal disease (ESRD) on thrice-weekly hemodialysis is admitted to the ICU with a high-grade fever and septic shock.

A Gram stain of her blood culture shows gram-positive budding yeast. Which culture medium should be used as the primary medium for fungal culture?

A 65-year-old woman with end-stage renal disease (ESRD) on thrice-weekly hemodialysis was admitted to the ICU with a high-grade fever and septic shock. She was empirically started on meropenem and vancomycin. A gram stain of her blood culture revealed gram-positive budding yeast cells, for which fluconazole was added.

The microbiology lab later informed that the colonies are dark brown with silver metallic sheen on BiGGY agar while microscopy of CMT is shown in picture. What would be your next step in addition to stopping antibiotics?

A 60 year old woman with multiple myeloma was treated with chemotherapy, followed by bone marrow transplant after 3 years. A year later, after relapse of the disease, she underwent radiotherapy and chemotherapy, and 4 years after the first BMT, was advised another one. While on myeosuppressive therapy before the second BMT, she developed painful vasculitis lesions in the lower abdomen and thigh.

Blood cultures initially grew Pseudomonas aeruginosa, and after worsening of condition the second set of blood culture turned positive, showing septate hyphae on gram stain. After 3 days of subculture on Saboraud's Dextrose Agar, growth of mold was observed; colony morphology and microscopic findings are shown in picture.

Identify the organism and suggest an antifungal agent

A 35-year-old man with a history of leukemia underwent a bone marrow transplant three weeks ago. He presents with fever, cough, and shortness of breath, and due to respiratory distress, he is intubated. His chest X-ray is shown in the picture. His procalcitonin level is negative. Tracheal cultures have grown Aspergillus terreus. Considering the possibility of invasive aspergillosis, which antifungal treatment would you start?

A 17-year-old man with aplastic anemia underwent hematopoeitic stem cell transplant after which he was kept on immune suppressive and homronal therapy. He developed fever after 7 months of the transplant. CT scan indicated sever pulmonary infection, and bronchoalveolar lavage was performed. Gram stain and Gomori methenamine silver staining showed bottle shaped and budding yeast cells. After 5 days, culture showed growth of creamy and fragile colonies on Saboraud's Dextrose Agar. Gram stain showed budding yeast cells with a collarette. Suspecting invasive Malassezia infection, what is the recommended method to enhance growth?

A 26 year old homeless man with a history of cough and low grade fever for three weeks presented to the clinic and suspecting tuberculosis, you sent his sputum for AFB smear, genexpert and routine culture. He had no other co morbids. Chest X ray showed upper lobe infiltrates. His AFB smear and genexpert turned out to be positive.
Sputum culture had numerous epithelial cells, few pus cells and grew no significant bacterial pathogens; however, the laboratory called to inform you that a mold was starting to grow on the plates (see picture). You suspect it to be Alternaria species. What do you think is the clinical significance?

A 55-year-old woman with a history of uncontrolled diabetes mellitus presents to the emergency department with facial pain, swelling around the eyes, nasal congestion, and black necrotic tissue on the palate. She has been feeling progressively unwell      over the past week, with a fever and malaise. On physical examination, she appears ill, with periorbital edema and erythema. Palatal scappings show broad aseptate fungal hyphae and she was started on IV amphotercin. On 6 weeks of therapy she improved clinically and radiologically. Now you are planning to discharge her on oral antifungal. Which oral antifungal would you prescribe her?

A 40-year-old gardener presents to the clinic with a painless, nodular lesion on his right hand that has developed into an ulcer. Over the past few weeks, several more nodules have appeared along the lymphatic channels of his arm. He reports a history of frequently handling thorny plants and soil. Skin lesion biosy was sent. Culture plate and microscopy from colonies is showing following growth. What is the likely cause?

The smell of rain is called petrichor. The compound that results in this smell is produced by organisms such as Actinomyces, Nocardia, and cyanobacteria. Humans can detect its presence in concentrations as low as 5 parts per trillion!
What is it called?