The presence of nonbudding, thick-walled spherules, 20 to 200 µm in diameter, containing either granular material or numerous small, nonbudding endospores, usually indicates infection with

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In direct microscopic examinations of sputum or other body fluids, C. immitis appears as a nonbudding, thick-walled spherule, 20 to 200 μm in diameter, containing either granular material or numerous small (2 to 5 μm in diameter), nonbudding endospores. The endospores are freed by rupture of the spherule wall; therefore, empty and collapsed "ghost" spherules may also be present.

The Presence of Nonbudding, Thick-Walled Spherules, 20 to 200 µM