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Mould Identification: A Virtual Self Assessment

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Unknown 5 = Uncinocarpus reesii

Case History
A 60 year old previously well male boilermaker presented with haemoptysis. He was a light smoker and had no travel history to the USA or South America. Chest X-ray showed hyper-inflated lungs and a CT showed upper lobe emphysema, no mass lesions were visible. Bronchial washings grew the fungus shown below.
Culture

Cultures on Sabouraud's dextrose agar showed a suede-like to downy, greyish white colony with a tan to brown reverse.
Microscopy

Microscopic morphology showing typical single-celled, hyaline, rectangular to barrel-shaped, alternate arthroconidia, separated from each other by a disjunction cell.

As both the culture and microscopic features closely resembled Coccidioides immitis an exoantigen test was done.

Exoantigen Test: showing a positive result for Coccidioides immitis.
Comment: Based on the above culture, microcopy and exoantigen results an initial identification of Coccidioides immitiis was made. However as the patient had no travel history to an endemic area a molecular identification using PCR amplification and sequencing of rDNA was performed which showed >98% homology to Uncinocarpus reesii.

Uncinocarpus reesii is a non-pathogenic, environmental saprophyte and is the closest known relative of Coccidioides immitis.  It is often used as a surrogate organism for laboratory training in the USA. However its cross reactivity with the exoantigen test has not been previously reported.

About Coccidioides Back to Virtual Assessment

What is your identification?

Coccidioides immitis
Uncinocarpus reesii
Malbranchea pulchella

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School of Biological Sciences
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THE UNIVERSITY OF ADELAIDE
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Dr David Ellis
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