Clinical History:
66 year old male s/p kidney transplant with pericardial effusion
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Choose the correct diagnosis:
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The answer is “B”, Cryptococcus pericarditis
Due to their immunosuppressed status, solid organ transplant recipients are frequently afflicted by opportunistic infections. In this case we see yeast-like organisms that show variation in size (pleomorphic), exhibit narrow budding and show a thick mucinous capsule as confirmed by the mucicarmine histochemical stain. All of these features are consistent with Cryptococcus sp organisms. Although in this immunosuppressed patient the organism in question is most likely Cryptococcus neoformans, the species Cryptococcus gattii can affect immunocompetent hosts.
References
Kradin RL, ed. Diagnostic Pathology of Infectious Disease. 2nd Edition. Philadelphia, PA: Elsevier; 2018
Contributed by Dr. Carlos Prieto Granada