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Electron Microscopy of Infectious AgentsCase 2: Solitary Intracranial Blastomycotic AbscessCase Presentation The patient in this case was an 11 year old boy from a rural area in Wisconsin who presented with a 4 month history of focal seizures in his right foot. The seizures progressed in severity to include the right leg and arm, and culminated in what was felt to be a grand mal seizure which brought him to hospital. Chest radiographs revealed a linear density at the left lung base interpreted at the time to be parenchymal scar. Cranial CT revealed a 1.2 cm mass in the left frontoparietal region. Cerebral angiography did not demonstrate tumor vascularity. The provisional diagnosis was primary brain tumor. At surgery a 1.3 cm mass with a tough, fibrous capsule was excised. A portion of the surgical material was cultured for the filamentous and yeast forms of the organism, and electron microscopy was performed on the filamentous culture samples. Subsequent bone, liver, and spleen scans and other tests to locate additional foci of infection were normal. The patient was treated and has completely recovered. Light Microscopy and Electron Micrsocopy Frozen sections demonstrated inflammatory cells and yeast forms diagnostic of a blastomycotic abscess. |
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 Figure 3 Magnify Image |
Electron microscopy of the specimen showed collapsed yeast forms within the cytoplasm of macrophages | |
 Figure 4 Magnify Image |
One of the yeast's was in the process of budding, with the daughter cell having a thinner wall | |
 Figure 5 Magnify Image |
Electron microscopy of mycelia after 3 days of culture showed well-preserved segmented conidiophores with round or pyriform conidia with prominent nuclei. | |
| Discussion | ||
| August 1998 Case-of-the-Month | ||