Presentation
A 30-year-old man with an existing HIV diagnosis presented to the emergency department with dizziness, lightheadedness and headaches, without cough or fever. The patient had been experiencing symptoms for about 4 days and was admitted to the ICU. Cerebrospinal fluid (CSF) culture, blood and a nasopharyngeal respiratory swab were collected and submitted to microbiology for polymerase chain reaction (PCR) panels, antigen testing and culturing.
The respiratory panel, the meningitis panel and the CSF cryptococcal antigen test were negative. The CSF and blood cultures became positive after the patient was discharged (around 40 hours of incubation), although initial Gram staining showed no organisms.
Subculturing showed small, colorless, gamma-hemolytic colonies on sheep blood agar and chocolate agar and no growth on MacConkey agar. Similar growth was observed on anaerobic media. Species identification was performed via MALDI-TOF and sent to the ARUP reference laboratory for susceptibility testing.
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Author Information
Ambrie Graham, MLT(ASCP)CM, Medical Laboratory Technician, Certified, Laboratory Services – 棉花糖直播, FirstHealth of the Carolinas.
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