On day 150, his rheumatologist had ordered a computerized
chest tomography (CT) scan, which revealed a 12-mm nodule with
spicular borders in the left lower lobe (Fig. 1). On day 30, this
nodule was biopsied by interventional radiology for exclusion of
malignancy. As the patient did not have any symptoms compatible
with an infectious process at that time, samples were sent for
histopathological examination only. Malignancy was ruled out, but
the pathology report described a suppurative, granulomatous inflammation
around fungal hyphal elements with the presumptive
diagnosis of a candida infection (Fig. 2).