The spleen was diffusely mottled in echotexture with multiple faint hypoechoic nodules up to 13 mm in size throughout the parenchyma. Fine needle aspirates of the spleen, and both medial iliac lymph nodes were performed and Wright's Giemsa stained direct smears were examined by light microscopy. 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.