A 40-year-old agricultural worker from Kerala presents with slowly progressive, verrucous, cauliflower-like lesions on the lower leg over several years. Biopsy shows large, round, thick-walled, brown pigmented cells with internal septations arranged singly or in clusters within giant cells. These structures are known as:

• A Muriform grains
• B Spherules with endospores
• C Sclerotic (Medlar) bodies ✓
• D Asterohyphal bodies

Explanation

Chromoblastomycosis, caused by pigmented (dematiaceous) fungi such as Fonsecaea pedrosoi, Cladophialophora carrionii and Phialophora verrucosa, shows characteristic sclerotic bodies, also called Medlar bodies or 'copper penny' cells, in tissue. These are thick-walled, brown, muriform cells that divide by internal septation rather than budding. Spherules with endospores indicate Coccidioides, while grains are seen in eumycetoma, a separate entity that also produces discharging sinuses.

Reference: Jawetz, Melnick and Adelberg's Medical Microbiology, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.