| Urine Potassium |
20 mmol/L |
7-147 mmol/L |
| Urine Sodium |
116 mmol/L |
0-260 mmol/L |
| Urine osmo |
345 mOsm/kg |
50-1,200 mOsm/kg |
| Urine Creatinine |
38 mg/dL |
19-311 mg/dL |
| Urine Magnesium |
7.3 mg/dL |
2-20 mg/dL |
| |
|
|
| LDH, Total |
289 U/L |
115-225 U/L |
| Lyme Antibodies Total |
Negative |
|
| P-ANCA |
< 1:20 titer |
Negative, <1:20 titer |
| C-ANCA |
<1:20 titer |
Negative, <1:20 titer |
| Saccharomyces cerevisiae Ab IgG |
20.7 |
1-25 U |
| Saccharomyces cerevisiae Ab IgA |
<20 units |
1-25 U |
| |
|
|
| % Neutrophils, Body Fluid |
89% |
|
| Appearance, Body Fluid |
Bloody |
|
| Color, body Fluid |
Red |
|
| Crystal Presence, Body Fluid |
None |
|
| Nucleated Cells, Body Fluid |
21,126 cells/uL |
|
| Red Blood Cells, Body Fluid |
390,000 cells/uL |
|
| Culture, Body Fluid, Aerobe |
Abundant White blood cells, polymorphonuclear, no squamous epithelial cells seen |
|
| Culture, Body Fluid, Anaerobe |
No anaerobes isolated. |
|
| Culture, Fungus, Smear |
Blastomyces species |
|
| Culture, AFB Smear |
No Acid-Fast Bacilli isolated. |
|
| Blastomyces Antigen Quant by EIA |
Detected |
|
| Blastomyces Antigen, Urine |
9.72 U/mL |
|
| Surgical Pathology, skin punch biopsy, right distal ulnar forearm |
Pallidum stain highlights spirochetes in the epidermis, consistent with syphilis |
|
| Surgical Pathology, skin punch biopsy, left thigh |
- Thick-walled yeast forms with broad-based budding; see Comment.
- Associated dermal pyogranulomatous inflammatory response.
- Immunostaining for Treponema pallidum is negative for spirochete
-The findings are suggestive of cutaneous blastomycosis |
|
| Surgical Pathology, Right knee, debridement with synovectomy |
– Granulomatous tenosynovitis with fungal yeast forms.
-Sections of the synovectomy show multiple small granulomas lining the synovial surface with an associated fibroinflammatory exudate. There are scattered multinucleated giant cells. Rare fungal yeast forms are identified. These are rounded with a thick cell wall and a few show budding with a broad base. The organisms are best seen on GMS stain, but are also found on a PAS stain for fungus. They are mucicarmine negative. The morphologic features are suggestive of blastomycosis however other dimorphic fungi cannot be excluded. No bacterial colonies are found on Gram stain. All controls stain appropriately |
|
|
|
|
|
|
|
| Histoplasma Galactomannan Ag, Urine |
2:1, positive |
>0.5 ng/mL |
| Cryptococcal Antigen |
Negative |
|
|
|
|
| Ferritin |
906 ng/mL |
24-336 ng/mL |
| Iron |
12 ug/dL |
45-190 ug/dL |
| TIBC |
189 ug/dL |
250-450 ug/dL |
| Iron Saturation |
6% |
20-55% |
| Haptoglobin |
>340 mg/dL |
37-308 mg/dL |