A “Kelp-Like” Microorganism Within the Belly

A 50-year-old woman suffering from paranoid schizophrenia with carelessness symptom was referred on day 0 for peritoni-tis caused by a perforated gastro-duodenal ulcer. In her recent medical history, anorexia, constipation, and impairment of general health condition were reported. A biological inflam-matory syndrome was noticed at admission, with C-reactive protein of 320.1 mg/L, procalcitonin of 216.68 µg/L, and polymorphonuclear neutrophil count of 16.4 × 10 9 /L. To note, blood calcium, total serum protein, and hemoglobin were low at 1.77 mmol/L, 40 g/L (including 16 g/L for albumin), and 81 g/L, respectively. Several intraperitoneal abscesses were detected by computed tomography on day 3 (Figure 1). Abscess aspirate showed a moderately inflammatory liquid with no malignant cells (day 4). On the third day following Figure 1. Medical imaging of abdomen. Noncontrast computed tomography scan showed 3 large abscesses within the peritoneum on day 3 (abscesses' sizes = 29.3 × 15.4 mm, 28.4 × 15.2 mm, and 82.2 × 47.1 mm). Figure 2. Microbiological findings from the abscess aspirate. A, After 6 days of culture, creamy, pale (instead of "whitish"), yeast-like colonies with flat rough texture. B, Microscopic observation of positive culture through fresh mounting (magnification ×400). C, Microscopic observation of positive culture according to calcofluor method (magnification ×400).