Case of the Month - November 2019
A 59 year old man with HIV infection, COPD, and heart failure developed
shortness of breath. He had been hospitalized two weeks earlier for
pneumonia and a COPD exacerbation and was treated with ceftriaxone and then
cefpodoxime to complete a 7 day course. His shortness of breath persisted
after he was discharged, so he was re-hospitalized. He also had a cough
with clear sputum but no fever. The patient takes prednisone 20 mg daily,
albuterol and budeonide-formoterol inhalers several times a day,
trimethoprim-sulfamethoxazole 160-800 three times a week, voriconazole 200 mg
daily, and a variety of cardiac medications.
Despite
broad-spectrum antibiotics, he improved only slightly, and eventually had
bronchoscopy with a lung biopsy. GMS stained lung sections are shown in
the figures (1000X).
What is the
organism?
|
GMS
stain, 1000X magnification (above and below)
|
|
|