Case 95

1. Presented by Kelly Craven, MD and reviewed by Sean Zhang, MD PhD.

An immunosuppressed child was outside playing when they fell and sustained a small abrasion on the extremity. They subsequently developed a fever and cellulitis and was admitted to the hospital. Blood cultures were sent and the patient was started on cefepime, levofloxacin, and vancomycin. After a couple days, a new ulcerated lesion developed on the ipsilateral extremity. Dermatology did a skin biopsy and sent it for bacterial, fungal, and mycobacterial cultures and the patient was started on amphotericin B. The skin biopsy showed fungal forms in the dermis with associated angioinvasion:

The fungal culture grew the following:

Which organism is most consistent with these findings?