Observation of yeast cells with multiple budding in tissue in the form of a “the shape shown in below pictomyograph ” is highly suggestive of
**Core Concept**
The question is testing the student's knowledge of dimorphic fungi and their characteristic microscopic features. Specifically, it involves the observation of yeast cells with multiple budding in tissue, which is a key distinguishing feature of certain fungal infections.
**Why the Correct Answer is Right**
Paracoccidioides brasiliensis, the causative agent of Paracoccidioidomycosis, is a dimorphic fungus that exhibits a characteristic "pilot wheel" or "ship's wheel" appearance due to multiple budding yeast cells. This appearance is a result of the fungus' ability to form large numbers of blastoconidia (asexual spores) on its surface. The presence of multiple budding yeast cells in tissue is a hallmark of Paracoccidioidomycosis and is often seen in histopathological specimens.
**Why Each Wrong Option is Incorrect**
**Option A:** Blastomycosis is caused by Blastomyces dermatitidis, which typically exhibits a single large bud (or "umbilicated" bud) on its surface, not multiple budding yeast cells.
**Option B:** Coccidioidomycosis is caused by Coccidioides immitis, which forms spherules (large, thick-walled structures) in tissue, not multiple budding yeast cells.
**Option D:** Histoplasmosis is caused by Histoplasma capsulatum, which typically forms small, intracellular yeast cells, not multiple budding yeast cells.
**Clinical Pearl / High-Yield Fact**
It's worth noting that the "pilot wheel" appearance of Paracoccidioides brasiliensis is a classic histopathological finding that can be seen in tissue sections from patients with Paracoccidioidomycosis. This appearance is often accompanied by granulomatous inflammation and can be used to diagnose the infection.
**✓ Correct Answer: C. Paracoccidioidomycosis**