DrVirgo
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45. A 35-year-old man who takes street drugs intravenously develops fever, cough, and hemoptysis. X-ray film of the chest shows bilateral infiltrates. Echocardiogram discloses a 1-cm mass that is attached to the tricuspid valve. Blood culture grows yeast. The most likely causal organism is
A ) Aspergillus flavus
B ) Candida albicans
C ) Cryptococcus neoformans
D ) Histoplasma capsulatum
E ) Mucor species
A? or B?
Which are a yeast invivo?
Please explain your answer.
Thanks. 
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| yasmeen
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I THINK ITS B AS ITS A YEAST DOES CAUSES ENDOCARDITIS AND AS HE IS IV DRUG ABUSER MAY HAS AIDS AND IMMUNOCOMPRESSION
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| r_albayunen
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ill go with B
endocarditis in the tricuspid valve suggests IVDA .... 2 must common MO staph and candida
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| robin082006
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I go with B too
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| DrVirgo
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Thanks. Thats what I thought as well. 
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| Cedrick
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B for sure
Candida albicans
Infective endocarditis in IV drug abusers and immunocompromised
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| bactitech
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Just to throw in a wrench: I had a real patient a couple of years ago who had a blood culture turn positive on day four (five day protocol). Gram stain showed yeast. It was identified as Cryptococcus neoformans. I would go with the C. neoformans, just from my experience. Doc said the patient was IV drug abuser who had signed herself out AMA (against medical advice). C. neoformans is a yeast that is seen in blood cultures with kidney transplant patients and others who are immunocompromised. We also see C. albicans infecting respiratory tracts (large amounts, pure culture from invasive procedure, not just a sputum with a few colonies) and causing esophagitis in patients who are HIV positive. Patients who grow C. neoformans usually have some underlying chronic debilitating disease and are immunocompromised/HIV positive.
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| Diego Casali
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B
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| truedeam59
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INTERESTING BACTITECH
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