After returning from a vacation trip to the Amazon River delta in Brazil, a man notices a white dirtlike substance on his axilla hair that does not wash off in the shower.His health care provider samples the hairs and sends them to the laboratory for culture.Straw-colored yeastlike colonies show the following microscopic morphology.This is most consistent with an identification of:

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Trichosporon spp.produce both arthroconidia and blastoconidia.White piedra occurs on the hair shaft and is characterized by a soft mycelial mat surrounding hair of the scalp, face, and pubic region.White piedra is endemic in tropical areas of South America, the Far East, and the Pacific.CDC PHIL #3936

After Returning from a Vacation Trip to the Amazon River