A 34-year-old man comes to the emergency department due to 2 weeks of slowly progressive global headache, malaise, and fevers. He has also had unintentional weight loss over the past several months. The patient has a history of injection drug use and was diagnosed with HIV 3 years ago. He has not been compliant with antiretroviral therapy. Temperature is 38.3 C (100.9 F). Examination shows white patches on the oropharyngeal mucosa and mild generalized lymphadenopathy. Brain imaging reveals no intracranial masses. Lumbar puncture reveals an elevated opening pressure, and cerebrospinal fluid analysis shows moderately increased protein concentration and pleocytosis. The latex agglutination test is positive for soluble polysaccharide antigen. Light microscopy of this patient's cerebrospinal fluid is most likely to reveal which of the following?

Question

A 34-year-old man comes to the emergency department due to 2 weeks of slowly progressive global headache, malaise, and fevers.  He has also had unintentional weight loss over the past several months.  The patient has a history of injection drug use and was diagnosed with HIV 3 years ago.  He has not been compliant with antiretroviral therapy.  Temperature is 38.3 C (100.9 F).  Examination shows white patches on the oropharyngeal mucosa and mild generalized lymphadenopathy.  Brain imaging reveals no intracranial masses. Lumbar puncture reveals an elevated opening pressure, and cerebrospinal fluid analysis shows moderately increased protein concentration and pleocytosis.  The latex agglutination test is positive for soluble polysaccharide antigen.  Light microscopy of this patient's cerebrospinal fluid is most likely to reveal which of the following?

Quizplus · Accepted Answer

Eductional Objective: Cryptococcus neoformans causes meningoencephalitis in patients with untreated AIDS.  Diagnosis can be made by detecting the polysaccharide capsule in cerebrospinal fluid using the latex agglutination test.  India ink staining of cerebrospinal fluid is also used for diagnosis and can demonstrate round or oval budding yeast.

A 34-Year-Old Man Comes to the Emergency Department Due to 2