Adventist University of the Philippines

Medical Laboratory Science Department

Medical Technology Assessment Program with

Clinical Correlations 1

Eddrei Paullynne D. Desoasido 2/24/23

CASE STUDY ANALYSIS WITH CLINICAL CORRELATION

MYCOLOGY

A 42-year-old airline pilot presented to the local hospital with increasing shortness of
breath, fever, and chills. The patient was though to have pneumonia and was treated with
ceftriaxone, after blood and sputum cultures were collected. Because the patient had recently
traveled to a malaria-endemic region, blood was sent for parasitic examination. The thick and
thin smears for Plasmodium species were negative. The patient’s condition continued to decline,
and he was referred to a tertiary care medical center. The blood cultures were negative. The
sputum cultures revealed only normal respiratory flora. The patient underwent bronchoscopy
with bronchoalveolar lavage (BAL). Direct examination of the BAL fluid using a calcofluor
white/potassium hydroxide (KOH) preparation revealed moderate-sized yeast with broad based
buds. The patient was started immediately on amphotericin B.
Questions:
1. What is the suspected organism?
Considering the systemic fungal infection, pneumonia, the suspected organism is
Blastomyces dermatitidis.
2. How does the laboratory confirm the identity of this pathogen?
Polymerase chain reaction (PCR) may be used to confirm the identity of the
pathogen.
3. Where did the patient likely acquire his infection?
Given the occupation of the patient, it is most likely that he acquired the infection
during his travel. Blastomycosis is commonly found in the Northern part of
America.