Case Study 1:  This 68-year-old North Carolina man with diab…

Questions

Cаse Study 1:  This 68-yeаr-оld Nоrth Cаrоlina man with diabetes mellitus was admitted to the hospital for evaluation of a persistent right lower lobe infiltrate.  Three weeks prior to admission, he presented to an outside physician for evaluation of fever, chills, weight loss, and anorexia.  A chest radiograph demonstrated a right lower lobe infiltrate.  He was treated with oral amoxicillin, but his condition worsened.  His PPD test was negative and three sputum specimens were negative for acid-fast bacilli on smear.  Sputum specimens were sent for fungal culture.  The patient works in a cotton mill in the so-called "opening room", where he opens bundles of cotton received from the southwestern United States.  Cultures of sputum and blood grew a mold which on microscopic examination had numerous rectangular alternating light and dark structures. Case Study 1.3:  What does this organism look like when grown in culture at 250C?