This beautiful photo is more sinister than you'd imagine: it's a slide of a multinucleated giant cell containing fungal elements. A 16-year-old young woman came to us on Tuesday with a nodule affecting her left nose. Radiographic imaging from a local hospital suggested a large, deep lesion involving the maxillary sinus that might have been a solid tumor; however, a fine needle aspiration biopsy revealed the mass was a benign fungal infection and not a malignancy. Post-surgically, we'll give her anti-fungal medicine, which should prevent any recurrence. 

We're fortunate to have Jeffrey Mueller, a pathologist from the University of Chicago, and his pathology resident Jefree Schultehere to perform on-site fine-needle aspirations, assessing cell specimens to diagnose tumors. Medical equipment is also in short supply, so Mueller brings his own. 

"With no pathologists in Malindi, and the nearest specialist two hours away in Mombasa, our pathologists' diagnoses are critical to our work here," says Jamie Wiggleton, ANP-BC, who runs our clinic here. Having instant diagnostic results is nearly unique to our mission trip: only a handful of others are also doing this. We don't receive pathology reports this quickly in the United States!