Abstract
A 7-year-old boy underwent an open lung biopsy as part of a workup for unexplained pulmonary infiltrates. Gomori's methenamine silver-stained sections revealed fungal hyphae in a background of chronic interstitial pneumonitis, with no evidence of abscess or granuloma formation. To explain this discrepancy, we cultured the light-green solution used as the counterstain. A dematiaceous fungus was isolated and identified as Exophiala jeanselmei. Without cultural identification of this fungus, observation of the hyphal forms in tissue sections could have led to the misdiagnosis of the patient's illness and inappropriate treatment.
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