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Pneumonia in California

3030 Views 5 Replies 3 Participants Last post by  rasheed, 
rasheed
A 45 year old women from California presented with fever, arthritis, pneumonia, and skin lesion over the anterior legs.
Skin scrapings treated with PAS stain revealed this
Pink Magenta Circle Art Foam

Image from CDC public domain - Dr. Gary Caroll

What is the treatment of choice
a- ampicillin
b- flucanazole
c- tetracycline
e- TMP-SMX
f- cephalosporin
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S
:confused:
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H
e?? This question drove me up the wall, lol. There are only a few organisms that are Acid fast and can stain with PAS. I was thinking Nocardia psuedoTB but I have no idea...:confused:
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rasheed
Answer

Diagnosis: Coccidiodis immitis
Treatment: Flucanazole
Clues: California, Pneumonia, Erythema nodosum
Micrograph: Tissue form, spherules
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H
Can you please just explain why it would stain with PAS?
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rasheed
HouseWannabe said:
Can you please just explain why it would stain with PAS?
Click to expand...
Coccidiodes can be stained by regular H&E stain or PAS stain
See this emedicine article
http://emedicine.medscape.com/article/297976-diagnosis
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