This week's case was kindly donated by Dr. Mike Mitchell and his laboratory. The patient is a middle-aged man with fever, intermittent cough, headache and mental status changes. He had a history of lymphoma and was receiving maintenance immunosuppressive chemotherapy. Of note, he had several episodes of bacteriemia and progressively worsening pulmonary infiltrates. He was originally from Sub-Saharan Africa but had been living in the United States for several decades.
The following are images from a duodenal aspirate: