Mycology: subcutaneous mycoses: practice question

A Microbiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Microbiology · Mycology: subcutaneous mycoses

Sample item

A gardener has a nodular lesion on the finger that progressed up the forearm as a chain of firm nodules along lymphatics, after a rose thorn prick. Biopsy shows cigar-shaped yeasts. What is the organism and treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Sporothrix schenckii, treated with itraconazole

Sporothrix schenckii is a dimorphic fungus found in soil and plants, causing lymphocutaneous sporotrichosis after traumatic inoculation ('rose gardener's disease'). Tissue shows cigar-shaped or oval budding yeasts. Itraconazole is first-line, with potassium iodide as an older alternative.

Option by option

  • A. Sporothrix schenckii, treated with itraconazole (correct)

    Correct. The history, lymphatic spread and cigar-shaped yeasts are typical.

  • B. Candida albicans, treated with nystatin

    Candida produces pseudohyphae and mucosal or invasive disease.

  • C. Cryptococcus neoformans, treated with amphotericin B

    Cryptococcus has a capsule and mainly causes meningitis.

  • D. Histoplasma capsulatum, treated with fluconazole

    Histoplasma lives in macrophages and causes pulmonary or disseminated disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Microbiology question

What is the answer to this Microbiology question?

The best answer is A, Sporothrix schenckii, treated with itraconazole. Sporothrix schenckii is a dimorphic fungus found in soil and plants, causing lymphocutaneous sporotrichosis after traumatic inoculation ('rose gardener's disease').

Why is "Candida albicans, treated with nystatin" not the answer?

Candida produces pseudohyphae and mucosal or invasive disease.

Why is "Cryptococcus neoformans, treated with amphotericin B" not the answer?

Cryptococcus has a capsule and mainly causes meningitis.

Why is "Histoplasma capsulatum, treated with fluconazole" not the answer?

Histoplasma lives in macrophages and causes pulmonary or disseminated disease.

What concept does this question test?

It tests Mycology: subcutaneous mycoses in Microbiology. Tissue shows cigar-shaped or oval budding yeasts. Itraconazole is first-line, with potassium iodide as an older alternative.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Mycology: subcutaneous mycoses?

Make a one-line identity card for each organism: shape and stain, defining test, toxin, disease and drug. Then use the flashcards and the other Microbiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.