Question

A 35-year-old rose gardener noticed a hard, immovable lump under the skin of his index finger but decided to ignore it. A month later, the lump ulcerated to present a black, necrotic appearance, and two more lesions developed further up the wrist and forearm. At this point, he visited his physician. A histologic stain of material from deep in the lesions showed rare elongated yeast cells resembling cigars. On SABHI agar at room temperature, a cream-colored leathery colony grew relatively rapidly, and after 9 days it started to turn back.

What disease is suspected and why? Give two reasons.

What would you expect to see in microscopic mounts from the SABHI?
-Hyaline cigar bodies
-Dematiaceous annellides with terminal conidia
-Hyaline daisy head flowerettes of conidia
-Single terminal, hyaline conidia
-Hyaline, tapering conidiophores with terminal balls of conidia

The etiologic agent is ubiquitous in nature. How did the patient probably contract the fungus?

Answer 1

The disease suspected in the patient is sporotrichosis (rose gardener's disease) due to the presence of elongated yeast cells resembling cigars in the histologic stain and the growth pattern on SABHI agar. Microscopic mounts from the SABHI would show hyaline, tapering conidiophores with terminal balls of conidia and hyaline cigar bodies. The patient likely contracted the fungus through direct contact with contaminated material in the environment.

Step-by-step explanation:

The disease suspected in the patient is sporotrichosis (rose gardener's disease)

Two reasons:

1. 
   
3. The histologic stain of material from deep in the lesions showed rare elongated yeast cells resembling cigars, which is a characteristic feature of Sporothrix schenckii, the causative agent of sporotrichosis.
4. 
   
6. The cream-colored leathery colony that grew on SABHI agar at room temperature and turned black after 9 days is consistent with the growth pattern of Sporothrix schenckii.

In microscopic mounts from the SABHI, you would expect to see:

• 
  
• Hyaline, tapering conidiophores with terminal balls of conidia.
• 
  
• Hyaline cigar bodies.

The patient probably contracted the fungus through direct contact with contaminated material in the environment. Sporothrix schenckii is ubiquitous in nature and is commonly found in soil, plants, and decaying vegetation.