PMC8742591_01
(a) Tissue culture showing growth of flat, off-white to cream, dry and finely suede-like colonies after 24 h of incubation on Sabouraud dextrose agar. (b) Lactophenol cotton blue stain microscopy at 1000x magnification showing hyaline, septate hyphae which break up into chains of hyaline, smooth, one-celled arthroconidia.
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F1
The culture of the tissue (Fig. 1a) showed growth of flat, off-white to cream, dry and finely suede-like colonies after 24 h of incubation at 25  C on Sabouraud dextrose agar. Lactophenol cotton blue stain (Fig. 1b) revealed hyaline, septate hyphae that break up into chains of hyaline, smooth, one-celled arthroconidia.
(a) Hematoxylin and eosin stain microscopy of tissue biopsy at 400x magnification showing a granuloma with central neutrophilic micro-abscess formation. (b) Periodic acid-Schiff stain microscopy of tissue biopsy at 400x magnification highlighting arthroconidia. (c) Grocott-Gomori's silver stain microscopy of tissue biopsy at 400x magnification showing fungal elements.
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F2
Some of the granulomas (Fig. 2a) show central neutrophilic micro-abscess formation. The presence of fungal hyphae is noted (Fig. 2a). Periodic acid Schiff (PAS) (Fig. 2b) and Grocott-Gomori's Methenamine Silver (Fig. 2c) stains highlighted the arthroconidia.
PMC8742591_02
Timeline of events shown in weeks since first presentation of patient.
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F3
Refer to Fig. 3 for the timeline.