A hyaline mold recovered from a patient with AIDS produced rose-colored colonies with lavender centers on Sabouraud dextrose agar. What is the most likely identification?

The description of the organism as a hyaline mold that produces rose-colored colonies with lavender centers on Sabouraud dextrose agar aligns best with Fusarium species. This group of fungi is known for its diverse morphology and coloration on culture media, often displaying vibrant hues, including the rose color indicated. Fusarium species are notable pathogens in immunocompromised individuals, including those with AIDS, making their identification particularly relevant in this context.

In this scenario, other genera, such as Wangiella, Exophiala, and Phialophora, while they may appear in similar clinical settings or on similar media, typically demonstrate different colony morphologies or color patterns that do not match the described rose and lavender appearance. For example, Wangiella generally exhibits black colonies and Exophiala might show dark green or black colonies as opposed to the distinctive colors noted. Phialophora also tends to produce darker colonies compared to the vibrant coloration observed in the described organism.

Thus, the combination of characteristic appearance on specific agar and its clinical association makes Fusarium spp. the most likely identification in this case.