Demonstration of fungal elements from cytologic preparations (i.e., sputa, inflammatory fluid aspirates from abscesses or sinusitis infection, and genitourinary and gynecologic specimens) may be difficult, due to the difficulty in extracting fungal elements from invaded tissues (8). Cultures of blood and cerebrospinal fluid (CSF) are negative. CSF, if inadvertently examined, may show an increased opening pressure, modest neutrophilic pleocytosis, normal or slightly elevated protein levels, or low glucose. In most cases, CSF study findings are normal. Smear and culture of sputum may be positive during cavitation of a lung lesion. Fine needle aspiration can yield a diagnosis, but should not preclude definitive therapy.
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