Case 2:

A 35 year old man presented with fever, cough with purulent sputum and a lobar consolidation on chest radiograph. Erythromycin was prescribed which he took for three weeks with no improvement. A further course of cefuroxime axetil was prescribed; after two more weeks the patient presented with bilateral pulmonary infiltrates, a right pleural effusion and multiple lesions of the skin which were verrucous. A biopsy of the skin lesion demonstrated broad base budding yeast with a thick highly refractile wall and multiple nuclei. Bronchoscopic specimens demonstrated similar yeast forms. Serologic tests for HIV were negative.

1. What characteristic morphologic forms help identify this pathogen?  What is the organism?

2. What is the source for this organism?
3. What are the virulant factors of this organism?
4. What are the major host defenses against this pathogen? 

5. What are risk factors for acquisition of this organism, and what is the portal of entry? 

6. What clinical syndromes are caused by this pathogen? 

7. What diagnostic procedures are helpful? 

8. What is the treatment of choice?