Discussion
Our case highlights the need for microbiological examination of
solitary pulmonary nodules detected in immunosuppressed patients.
Although the major differential diagnosis is malignancy for
such nodules, fungal organisms may well be the etiological agent,
particularly in immunosuppressed patients. Biopsy is usually
performed to rule out malignancy; however, once the specimen is
placed in formalin, the opportunity for culture is lost, which is the
gold standard in identification of fungal element. As in our case,
when culture opportunity is lost or there is no growth in culture, a
molecular approach may be quite useful in identification of fungal
species.