PMC9561240_01
Colonoscopy revealed scattered ulcers with unknown etiology located at transverse colon (A) and the ascending colon (B). H&E staining showed infiltration of clustered microorganisms and granulomas in the lamina propria at x200 (C) and x400 (D). PAS staining revealed some intracellular and extracellular yeasts (yellow arrow) distributed in the colon at x400 (E) and higher magnification (F). GMS staining showed abundantly septate yeast-like microorganisms (yellow arrow) at x400 (G) and higher magnification (H). PAS, periodic acid-Schiff; GMS, Gomorrah's methylamine silver.
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A colonoscopy revealed multiple scattered and swollen ulcers in the ileocecal region and ascending, transverse, descending, and sigmoid colon, and multiple site biopsies were performed ( Figures 1A, B ). After 7 days, histopathological evaluation of the biopsies using hematoxylin and eosin staining revealed a chronic ulcer of the colonic mucosa with fungal granuloma and focal small abscess ( Figures 1C, D ). Figures 1E, F ) and GMS ( Figures 1G, H ) staining of the intestinal biopsy specimens were positive. Fungal spores with a transverse septum were observed in the tissue cells, which were presented in the form of short fusiform or sausage-shaped spores aggregated into mulberry shapes.