A cytological diagnosis of granulomatous splenitis and neutrophilic lymphadenitis associated with the presence of macrophages containing branching, septate fungal hyphae was made, consistent with a multi-organ fungal infection (Fig. 1). Urinalysis showed mild haematuria, few granular casts and severe proteinuria (Table 1). Fungal hyphae were not identified on urine sediment examination.