#00012538

16-month-old boy with a history of chronic intestinal dysmotility requiring total parenteral nutrition was admitted with a suspected line-related sepsis. He had a leukocyte count of 4.3 x 109/L, hemoglobin 73 g/L, and platelets 43 x 109/L. Electrolytes, urea, creatinine, coagulation parameters, and liver function tests were all within normal ranges. On the peripheral blood smear, a microcytic anemia with thrombocytopenia was present along with intracellular and extracellular organisms (see figures), some with budding (arrows), in keeping with a fungal sepsis. Fluconazole was started empirically and subsequent blood cultures revealed Candida albicans as the causative agent 2 days later. Candida species accounts for approximately 9% of hospital-acquired infections in the United States. Consequently, systemic fungal infections have become an important cause of morbidity and mortality, especially in the immunocompromised population.