Large round cells (double-walled)

• Specimen: Sputum

• A: Gram stain

• B: Modified Kinyoun x1000

• C: Calcofluor White x400

• Large round, double-walled budding yeast with broad base are consistent with Blastomyces

• Blastomyces was not picked up by the Gram smear reader. General bacteriology staff usually do not search for structures other than bacteria unless asked specifically.

• Modified Kinyoun stains Blastomyces