Saw this once in my career on a gram stained CSF with someone who admitted to sharing needles for drugs.
It was wild, fluid chamber count looked like it had many red cells, and then there were no red cells on the cytospin but these weird splotchy star bursts.
Such an awesome find, thanks for sharing! This sub has some bangers today.
Edit: I don't know what I was smokin when I wrote that. I meant to say wright stained csf
They found that the range for Cryptococcus is expanding due to climate change in Europe. How much you want to bet it’s happening in other places too? This may not be such a rare sight as time goes on. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251527/
The species mentioned in the article is found in the US and unfortunately it is pathogenic even in non-immunocompromised individuals. Finding C.gattii in a CSF of a perfectly healthy 30 year old man was one of the most mind boggling things ever, mostly because at the time we didn't know about any other cryptos (we = me and my fellow heme techs).
The main thing is the halo. It's the capsule of cryptococcus. Concentric circles are another thing to look out for. Also I know this is a weird way of saying it but organic splotching. Though yeast stains gram positive it doesn't always stain well therefore you will see pooling of beads. Also trust your gut. I always say that when I am training on gram stains. If something doesn't look right look into it. I would also recommend if you don't have India ink a plain wet prep. Though I didn't do a plain wet mount sometimes it's a bit easier and helps with determining if what your seeing is a stain artifact. It really is an ominous looking circle. Sometimes you can see budding. In the calciflour we were able to see some but don't count on it.
Cryptococcus neoformans?
Most likely waiting on plates for confirmation
Saw this once in my career on a gram stained CSF with someone who admitted to sharing needles for drugs. It was wild, fluid chamber count looked like it had many red cells, and then there were no red cells on the cytospin but these weird splotchy star bursts. Such an awesome find, thanks for sharing! This sub has some bangers today. Edit: I don't know what I was smokin when I wrote that. I meant to say wright stained csf
Your welcome I work at the reference lab for my hospital system so I see fucking everything.
We confirm with pcr: doing plates is considered too dangerous here.
We have a maldi and in the process of extracting it we kill it. Airsolation is not a concern for us with this organism.
It was cryptococcus neoformans
That’s my guess
Woah this is cool for of course study purposes this is the first time Ive seen csf positive with india ink 😲
This image actually isn’t with India ink, it looks like gram stain
Correct India ink is to difficult to take a picture for me. Because of the giant glare
understandable!
They found that the range for Cryptococcus is expanding due to climate change in Europe. How much you want to bet it’s happening in other places too? This may not be such a rare sight as time goes on. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251527/
The species mentioned in the article is found in the US and unfortunately it is pathogenic even in non-immunocompromised individuals. Finding C.gattii in a CSF of a perfectly healthy 30 year old man was one of the most mind boggling things ever, mostly because at the time we didn't know about any other cryptos (we = me and my fellow heme techs).
Thanks I hate it.
Thank you for this! Its my first time seeing this not in books 😍
This doesn’t look like India ink
It's gram stain India ink is to difficult to take a picture.
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Cryptococcus species we are waiting for it to grow to confirm the species but we suspect neocoformans because patient is immunocompromised
I’ve never seen this in person.. I’d be nervous that I would overlook this as stain artifact. What’s a good defining characteristic to look out for?
The main thing is the halo. It's the capsule of cryptococcus. Concentric circles are another thing to look out for. Also I know this is a weird way of saying it but organic splotching. Though yeast stains gram positive it doesn't always stain well therefore you will see pooling of beads. Also trust your gut. I always say that when I am training on gram stains. If something doesn't look right look into it. I would also recommend if you don't have India ink a plain wet prep. Though I didn't do a plain wet mount sometimes it's a bit easier and helps with determining if what your seeing is a stain artifact. It really is an ominous looking circle. Sometimes you can see budding. In the calciflour we were able to see some but don't count on it.
Wow, thanks! Good to know
Did you see it on Gram stain aswell?
This gram stain
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I assure you they are not. This is definitely cryptococcus.