A 35-year-old man with HIV complains that he has had a “bad” taste in his mouth and discoloration of his tongue for the past 6 weeks There are areas of adherent, yellow-tan, circumscribed plaque on...

A 35-year-old man with HIV complains that he has had a “bad” taste in his mouth and discoloration of his tongue for the past 6 weeks

There are areas of adherent, yellow-tan, circumscribed plaque on the oropharynx and the tongue This plaque can be scraped off as a pseudomembrane to show an underlying granular, erythematous base The material is composed of organisms and inflammatory debris Gram stained smear shows yeast with pseudohyphae Culture shows pearly colonies typical of yeast Germ tube test is positive Invasive infections may occur in immunocomprised individuals Pseudohyphae may be seen in tissue section with PAS stain

What is the MOST LIKELY diagnosis? What is a likely causative organism? What is the possible treatment?

In a separate case, a blood culture from a neutropenic (