Question

Gerry is a 13 year old boy who has acute leukemia. Due to this disease, he is immunocompromised. His father raises pigeons in their garage.

Gary becomes very somnolent and is taken to the ER. The attending physician decides to take a CSF sample and the lab result shows large cells (25 um in diameter) with a capsule. What do you think this could be?
A.It could be the white blood cells that have invaded the CSF
B.It could be Cryptosporidium parvum
C.It could be Cryptococcus neoformans
D.It could be a bacterial infection like Streptococcus pneumoniae

Answer 1

Gerry's CSF sample showing large encapsulated cells suggests an infection with Cryptococcus neoformans, likely due to his exposure to pigeon droppings and compromised immune system.

Step-by-step explanation:

The large cells (25 um in diameter) with a capsule found in Gerry's CSF sample could most likely be Cryptococcus neoformans. This type of fungal pathogen is commonly found in bird droppings and is known to cause cryptococcal meningitis, especially in individuals who are immunocompromised like Gerry. Considering the environment around Gerry, with exposure to pigeon droppings in the garage, and his symptoms, C. neoformans is a very probable cause of the infection. While the other choices could also theoretically cause illness, the specific details provided about the cells are most consistent with C. neoformans. This pathogen would not be affected by antibiotics, as they target bacteria, not fungi. Instead, antifungal medications such as amphotericin B and flucytosine are used to treat infections caused by C. neoformans.