A 25 years old female complains of recurrent rhinitis, nasal discharge and bilateral nasal blockage since one year. She has history of asthma and allergy. On examination multiple ethmoidal polyps are noted with mucosal thickening and impacted secretions in both the nasal cavities. Biopsy is taken and the material is cultured which shown the growth of many hyphae and pseudohyphae with dichotomous branching typically at 45 degree. Which of the following is the most likely responsible organism?
High-Yield Explanation
1. Key points towards diagnosis: - Recurrent rhinitis, nasal discharge, bilateral nasal blockade. - H/O asthma and allergy - Hyphae with dichotomous branching at 45 degree 2. All points goes towards Aspergillus infection. - Most common type of fungal infection of nose and paranasal sinuses are due to aspergillus. - Aspergillus has septate hyphae that branch typically at 45 degree (V shaped). 3. Hyphae with dichotomous branching at 45 degree in Gomori Methenamine Silver stain: -Broad aseptate hyaline hyphae with wide angle branching seen in members of Zygomycetes.i.e rhizopus and mucor - Candida: GPOBYC (gram positive oval budding yeast cell) with pseudohyphae.