Question:medium
An HIV positive patient with a CD4 count of 300/cumm presents with mucosal lesions in the mouth as shown in the figure. On microscopy, budding yeasts and pseudohyphae are seen. The most probable diagnosis is:
An HIV positive patient with a CD4 count of 300/cumm presents with mucosal lesions in the mouth as shown in the figure. On microscopy, budding yeasts and pseudohyphae are seen. The most probable diagnosis is:
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Budding yeasts plus pseudohyphae name the organism directly.
Updated On: Jun 23, 2026
- Candidiasis
- Hairy leukoplakia
- Lichen planus
- Diphtheria
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The Correct Option is A
Solution and Explanation
Let the microscopy lead: budding yeasts plus pseudohyphae is a Candida albicans signature, so the oral lesion is candidiasis (thrush), the commonest opportunistic mouth infection in HIV. Removable white curd-like plaques over a red base fit perfectly.
Rule out the look-alikes by their hallmark. Oral hairy leukoplakia is an EBV-driven corrugated white plaque on the side of the tongue that will not rub off and lacks fungi. Lichen planus shows reticular Wickham striae with a subepithelial band of T lymphocytes. Diphtheria gives a tough grey pharyngeal pseudomembrane from Corynebacterium diphtheriae. Since none of these shows yeasts and pseudohyphae, the answer is candidiasis.
Ref: Robbins Basic Pathology, pg 502-503.
Rule out the look-alikes by their hallmark. Oral hairy leukoplakia is an EBV-driven corrugated white plaque on the side of the tongue that will not rub off and lacks fungi. Lichen planus shows reticular Wickham striae with a subepithelial band of T lymphocytes. Diphtheria gives a tough grey pharyngeal pseudomembrane from Corynebacterium diphtheriae. Since none of these shows yeasts and pseudohyphae, the answer is candidiasis.
Ref: Robbins Basic Pathology, pg 502-503.
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