A 54-Year-Old Man Is Brought to the Emergency Department Due

A 54-year-old man is brought to the emergency department due to a week of progressive headaches and confusion.  He was treated for viral esophagitis 6 months ago and Pneumocystis pneumonia 2 months ago.  Temperature is 38 C (100.4 F) , blood pressure is 142/86 mm Hg, and pulse is 64/min.  The patient is lethargic and oriented to person and place only.  CT scan of the head shows a mildly increased ventricle size but no other abnormalities.  Lumbar puncture reveals an elevated opening pressure, and cerebrospinal fluid analysis shows moderately increased protein concentration and pleocytosis.  The latex agglutination test is positive for soluble polysaccharide antigen.  Light microscopy of this patient's cerebrospinal fluid is most likely to reveal which of the following?

A) Budding yeast
B) Germ tubes
C) Nonseptate hyphae
D) Spherules with endospores
E) Sporangium

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