Rapidly Progressive Disseminated Sporotrichosis as the First Presentation of HIV Infection in a Patient with a Very Low CD4 Cell Count

Figure 2

(a) Hematoxylin and eosin stain (original magnification 100x) discloses a dermal chronic granulomatous inflammatory reaction, with the presence of Langhans giant cells, epithelioid histiocytes, plasmocytes, neutrophils, and eosinophils. (b) Hematoxylin and eosin stain (original magnification 400x) shows abundant rounded structures located inside multinucleated giant cells and histiocytes. (c) Periodic acid-Schiff stain (original magnification 200x) discloses spherical fungal elements. (d) and (e) Grocott’s methenamine silver stain (original magnification 100x and 200x, resp.) unmasks countless 2 to 6 μm darkly stained round to oval, as well as some cigar-shaped, elongated unicellular yeast-like structures, consistent with Sporothrix spp. (f) A cigar-shaped structure (black arrow) and a narrow-based budding yeast (white arrow) are shown in detail.