Infections: bacterial, viral, fungal, parasitic: cutaneous histoplasmosis: practice question

A Dermatology 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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Dermatology · Infections: bacterial, viral, fungal, parasitic: cutaneous histoplasmosis

Sample item

A man with advanced HIV infection has fever, hepatosplenomegaly and umbilicated papules and ulcers on the face. Biopsy shows 2 to 4 micron oval budding yeasts packed within macrophages, with a clear halo, and mucicarmine staining is negative. Which organism is responsible?

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

The answer and the reasoning

D. Histoplasma capsulatum

Disseminated histoplasmosis shows small intracellular yeasts within macrophages. The absent mucicarmine staining shows there is no mucopolysaccharide capsule, which excludes Cryptococcus. Treatment of disseminated disease is with amphotericin B followed by itraconazole.

Option by option

  • A. Cryptococcus neoformans

    Cryptococcus has a mucicarmine-positive capsule and is larger and mostly extracellular.

  • B. Candida albicans

    Candida forms yeasts with pseudohyphae and is not a macrophage-packed 2 to 4 micron yeast.

  • C. Blastomyces dermatitidis

    Blastomyces is a larger yeast, 8 to 15 microns, with broad-based single buds.

  • D. Histoplasma capsulatum (correct)

    Correct. Tiny intracellular yeasts in macrophages without a capsule fit Histoplasma.

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.

More Dermatology questions

Questions about this Dermatology question

What is the answer to this Dermatology question?

The best answer is D, Histoplasma capsulatum. Disseminated histoplasmosis shows small intracellular yeasts within macrophages.

Why is "Cryptococcus neoformans" not the answer?

Cryptococcus has a mucicarmine-positive capsule and is larger and mostly extracellular.

Why is "Candida albicans" not the answer?

Candida forms yeasts with pseudohyphae and is not a macrophage-packed 2 to 4 micron yeast.

Why is "Blastomyces dermatitidis" not the answer?

Blastomyces is a larger yeast, 8 to 15 microns, with broad-based single buds.

What concept does this question test?

It tests Infections: bacterial, viral, fungal, parasitic: cutaneous histoplasmosis in Dermatology. The absent mucicarmine staining shows there is no mucopolysaccharide capsule, which excludes Cryptococcus. Treatment of disseminated disease is with amphotericin B followed by itraconazole.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Infections: bacterial, viral, fungal, parasitic: cutaneous histoplasmosis?

Learn each condition by its primary lesion, site and signature sign. Then use the flashcards and the other Dermatology 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.