Night at the Lab: We had India Ink
Whenever a sample from an immunocompromised patient comes around, there's a good chance we'd find something uncommon. Lo and behold, my colleague found something under the scope.
He suspected that it could be Cryptococcus neoformans. The suspicion alone was enough for us to take different precautions with the patient's culture. Trying to relive the old school days, he wanted to see if we had any India ink to visualize the potential fungus under the microscope. Funnily enough, we procured some ink from the histology department.
The pictures I tried to take were horrendous. They were the equivalent of taking shots of the moon with your smartphone. The white dots were supposed to be the fungus.
As expected, bringing the image to an external display didn't work either. The contrast alone made visualization impossible without witnessing it yourself.
source
The picture above is what you are supposed to see under the scope. I hope you can make sense of the terrible photos from earlier with this representation.
The last thing we needed to do was set up fungal cultures for this patient. In addition, we moved the routine cultures off of automation. They had to be sealed with parafilm and could only open under BS2 environment. In days' time, we can confirm the identity of the fungus we saw in the stains.
Cryptococcus neoforman is an interesting species. It's a radiotrophic fungus that can thrive in extreme radioactive conditions. I recall there was little information online about radiosynthesis 10 years ago.
Fortunately for us, this particular fungus is usually an opportunistic infection. I still wouldn't go breathing them in, though. You can read more about it on the CDC website.
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Wow, that is pretty intense! I get what you are saying about the photos. If I squint really hard I can make it look like the last one you shared :)
Yeah, cameras today still have limitations in that area.
luckly it doesn't spread in the hospital
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It shouldn’t when controlled properly.
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Isn't this how The Last Of Us get's started?
On a different note, there is a fungus in the desert I'm always worried about. I don't remember what it's called, but it's really bad for you if you inhale it. I'm still alive so I guess it hasn't found me yet....
Coccidioides aka Valley Feaver?
https://en.wikipedia.org/wiki/Coccidioides
Yup, that's it! Scary stuff, but YOLO!
Yeah, we get those occasionally.
What's the weirdest you have found,?
In terms of fungal infection?
UTI caused by Saccharomyces cerevisiae. Life is pretty terrible when you are so immunocompromised, brewers’ yeast cause you problems.
So...she peed alcohol?
Nope.
Sad
Never seen something like this, you are handling the first case like this or it is your regular routine to handle cases like this ?
I’ve been there.