Alette, a 17-year-old Haitian woman, presented to a women’s clinic complaining of watery and foamy bowel movements 5 to 10 times a day. She had also experienced abdominal cramps and a low-grade fever. The physician ordered a stool sample for routine O&P as well as for culture and sensitivity tests. The culture and sensitivity tests were reported as negative for enteric pathogens. The laboratory technician performed a routine O&P examination, including a permanent trichrome stain. No parasites were observed. Two days later, a repeat O&P was ordered. The patient was now diagnosed as HIV-positive. The repeat sample was again examined for ova and parasites by routine laboratory procedures. This time, the technologist noted oval forms of the wet preps that were highly refractile and suggestive of fungal cells, but no budding was seen. The trichrome permanent stain did not confirm the laboratory technician’s suspicions. Not satisfied that the sample was negative, the laboratory technician performed an alternative permanent stain. These organisms were noted as 5 µm in size with one to six dark granules within their cytoplasm. What is the most probable disease associated with the infection? What morphologic form? What organism did the laboratory technician suspect, and why?

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Alette, a 17-year-old Haitian woman, presented to a women’s clinic complaining of watery and foamy bowel movements 5 to 10 times a day. She had also experienced abdominal cramps and a low-grade fever. The physician ordered a stool sample for routine O&P as well as for culture and sensitivity tests.

The culture and sensitivity tests were reported as negative for enteric pathogens. The laboratory technician performed a routine O&P examination, including a permanent trichrome stain. No parasites were observed.
Two days later, a repeat O&P was ordered. The patient was now diagnosed as HIV-positive. The repeat sample was again examined for ova and parasites by routine laboratory procedures. This time, the technologist noted oval forms of the wet preps that were highly refractile and suggestive of fungal cells, but no budding was seen. The trichrome permanent stain did not confirm the laboratory technician’s suspicions. Not satisfied that the sample was negative, the laboratory technician performed an alternative permanent stain. These organisms were noted as 5 µm in size with one to six dark granules within their cytoplasm.

What is the most probable disease associated with the infection?

What morphologic form?

What organism did the laboratory technician suspect, and why?

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