This week's case was donated by Dr. Andrew Bryan, Molly Weatherholt, Clarissa Ljungren, Bashi Ebrahimi, and Jacob Karsten. These striking images are from skin scrapings from an elderly patient with suspected superficial cutaneous fungal infection. The material was stained with Calcofluor white and examined with fluorescence microscopy. Diagnosis? What are the objects seen here - the big and little ones?
7 comments:
Scabies
For sure the large objects are itch mites Sarcoptes scabiei. We do find them on neglected elderly patients especially when institutionalized. The smaller fluorescent cells are compatible with fungal cells, though I can’t match them with dermatophytes as these usually display hyphae and arthroconidia. They don’t show the typical “spaghetti and meatballs” of Malassezia furfur. I wouldn’t rule out a yeast infection.
Beautiful images. They look like they were taken from the Hubble Telescope.
Scabies, and a lot of their poops!
I agree: Sarcoptes scabiei (itch mite) - both adult and baby (nymph) on the first and last picture - and their scyballa.
Boy I do need to brush off the rust, can’t recognize the mites dung anymore.
Hi Florida Fan!
Well… I don’t have experience seeing that dung with a fluorescent microscope… so I hope I’m right on this one 😅.
It’s just that the small stuff on the 2nd image has the right size and the typical “puck”-shape with a dent, to be compatible with mite-droppings. So: fingers crossed!
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