A diabetic with orbital cellulitis and maxillary sinusitis shows hyaline, narrow, septate and ranching hyphae with invasion of the blood vessels fungus on microscopy. Which is the causative fungus ?
**Core Concept**
Aspergillosis is a fungal infection caused by Aspergillus species, which can lead to various conditions including invasive aspergillosis, allergic reactions, and colonization in immunocompromised patients. In the context of orbital cellulitis and maxillary sinusitis, Aspergillus species can cause invasive fungal sinusitis, characterized by tissue invasion and potential spread to surrounding structures.
**Why the Correct Answer is Right**
Aspergillus species are known for their ability to invade blood vessels and cause tissue damage, which is evident in the given microscopic description of narrow, septate, and branching hyphae. The hyphae of Aspergillus species are typically 2-6 μm in diameter, septate, and have a characteristic "beaded" or "spherules" appearance. This description is consistent with Aspergillus species, which are known to cause invasive aspergillosis, particularly in immunocompromised patients. The invasion of blood vessels by Aspergillus species is a hallmark of invasive aspergillosis, which can lead to severe tissue damage and dissemination.
**Why Each Wrong Option is Incorrect**
**Option A:** Candida species typically exhibit pseudohyphae and blastoconidia on microscopy, which is not consistent with the given description.
**Option B:** Rhizospora is not a recognized genus of fungi, and it is likely a distractor.
**Option D:** Histoplasma capsulatum is a dimorphic fungus that typically exhibits small, intracellular yeast forms on microscopy, which is not consistent with the given description of branching hyphae.
**Clinical Pearl / High-Yield Fact**
Aspergillus species are opportunistic pathogens that thrive in immunocompromised patients, particularly those with diabetes, neutropenia, or chronic lung disease. Invasive aspergillosis should be suspected in patients with severe immunosuppression and symptoms of sinusitis, orbital cellulitis, or other invasive fungal infections.
**✓ Correct Answer: C. Aspergillus**