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Matthew T Koroscil, Andrew Skabelund
Introduction: Blastomyces dermatitidis is a dimorphic fungus endemic to the Mississippi River valley. We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL)...
March 14, 2018: Military Medicine
Joseph A McBride, Gregory M Gauthier, Bruce S Klein
This review article focuses on the mechanisms underlying temperature adaptation and virulence of the etiologic agents of blastomycosis, Blastomyces dermatitidis, Blastomyces gilchristii, and Blastomyces percursus. In response to temperature, Blastomyces undergoes a reversible morphologic switch between hyphae and yeast known as the phase transition. The conversion to yeast for Blastomyces and related thermally dimorphic fungi is essential for virulence. In the yeast phase, Blastomyces upregulates the essential virulence factor, BAD1, which promotes attachment to host cells, impairs activation of immune cells, and blunts cytokine release...
March 13, 2018: Virulence
Douglas Challener, Omar Abu Saleh
A 51-year-old woman from Wisconsin with past medical history of kidney transplantation from her sibling 8 weeks prior, presented with symptoms of shortness of breath, cough and a new skin rash over a 2-week period. She has just finished a 10-day course of levofloxacin for pneumonia without improvement. On presentation she was afebrile and her exam was remarkable for few discrete pustular lesions over the face, back and the soles (Figure 1). This article is protected by copyright. All rights reserved.
March 7, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Jessica Mak, Ayman Al Habeeb, Mona Al Kalabi, Afsaneh Alavi
Blastomyces dermatitidis is typically contracted through inhalation of the dimorphic conidia, resulting in pulmonary infection as well as extrapulmonary disease through hematogenous spread. Blastomycosis is considered one of the great mimickers in medicine, with verrucous cutaneous blastomycosis resembling skin malignancy and B dermatitidis pulmonary infections often confused with lung cancer. Cutaneous blastomycosis can also often mimic pyoderma gangrenosum and should be considered in the differential diagnosis in any suspected case...
February 1, 2018: Journal of Cutaneous Medicine and Surgery
Stephanie Kao, Ramsin Yadgar, Thomas Enelow, Adam Friedman
Blastomycosis-like pyoderma (BLP) is a rare reactive skin disease that is most commonly caused by bacterial infection. Herein we present a case of BLP arising in lichen planus, a chronic inflammatory disease. We propose Wolf's isotopic response, or the appearance of a new skin disease at the site of an existing and unrelated disease, as the underlying molecular mechanism responsible for this unusual physical presentation. It is important that clinicians recognize atypical morphologies such as BLP, which mimics squamous cell carcinoma both clinically and pathologically...
February 1, 2018: Journal of Drugs in Dermatology: JDD
Daniel Dalcin, Roger Sandre
No abstract text is available yet for this article.
December 11, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Sherman J Alter, Megan B McDonald, Julie Schloemer, Ryan Simon, Julian Trevino
Cutaneous infections and infestations are common among children and adolescents. Ectoparasitic infestations affect individuals across the globe. Head lice, body lice, scabies, and infestations with bed bugs are seen in individuals who reside in both resource poor areas and in developed countries. Superficial cutaneous and mucosal candida infections occur throughout the life cycle. Dermatophyte infections of keratin-containing skin and skin structures result in tinea capitis (scalp), tinea corporis (body), tinea pedis (foot), and tinea unguium (nails)...
January 2018: Current Problems in Pediatric and Adolescent Health Care
Andrew Walkty, Yoav Keynan, James Karlowsky, Perry Dhaliwal, John Embil
Blastomyces dermatitidis is a thermally dimorphic fungus that is capable of causing pulmonary and extra-pulmonary disease, including infections of the central nervous system (CNS). Diagnosis of CNS blastomycosis with non-invasive testing can be difficult, and a surgical biopsy may ultimately be required for microbiological and/or histopathological confirmation. A case of B. dermatitidis meningitis is presented where the diagnosis was made by testing cerebrospinal fluid (CSF) using the MVista® Blastomyces Quantitative Antigen Enzyme Immunoassay test...
February 2018: Diagnostic Microbiology and Infectious Disease
Barry Ladizinski, Nicole Joy, David C Reid
No abstract text is available yet for this article.
January 2018: Journal of Emergency Medicine
Anna Beltrame, Patrizia Danesi, Claudio Farina, Pierantonio Orza, Francesca Perandin, Claudia Zanardello, Paola Rodari, Silvia Staffolani, Zeno Bisoffi
Lobomycosis is a chronic skin mycosis endemic in Amazon regions characterized by chronic nodular or keloidal lesions caused by Lacazia loboi , an uncultivable fungus. Imported cases in nonendemic countries are rare and diagnosed after years. We describe a case of lobomycosis in a healthy 55-year-old Italian traveler who had acquired the infection during 5-day-honeymoon in the Amazon region of Venezuela in 1999. Several weeks after return, he recalled pruritus and papular skin lesions on the left lower limb, subsequently evolving to a plaque-like lesion...
December 2017: American Journal of Tropical Medicine and Hygiene
M Ben Salem, M Hamouda, M Mohamed, S Aloui, A Letaief, A Moussa, H Skhiri, A Zakahama, N Ben Dhia
Fungal infections have an important role in organ transplant recipients, and in some cases can be lethal. Blastomycosis is rare in kidney transplantation. We present a case of cutaneous blastomycosis in a kidney transplant recipient in Tunisia, a country outside the known endemic countries. This case, with the very uncommon and unexpected diagnosis of blastomycosis, demonstrates the diversity of infections in transplant recipients and reflects the importance of histologic and serologic tests in the immunocompromised patient...
September 2017: Transplantation Proceedings
Jennifer L Hsu, B Joel Tjarks, Aaron Berg, Tony Oliver
Blastomycosis is an endemic fungal infection commonly found within the Mississippi and Ohio River basins and Great Lakes region. While patients typically present with acute pneumonia, Blastomyces dermatitidis has the potential to spread hematogenously, resulting in disseminated infection of multiple organs. In this report, we describe a 57-year-old male with disseminated blastomycosis acquired in South Dakota. The diagnostic evaluation was confounded by concern for malignancy given the involvement of multiple locations, including brain, lungs, adrenal glands, and testes...
April 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Aiham H Jbeli, John Yu
Malignant glioblastoma multiform (GBM) is the most common primary malignancy of the brain in the U.S. Temozolomide (TMZ) is the cornerstone of management along with surgical resection and radiotherapy. Because of the reduction in the CD4+ lymphocyte count as a side effect of TMZ use, this patient population is under risk for opportunistic infections like Pneumocystis jiroveci. A male patient with newly diagnosed glioblastoma multiform presented with non-productive cough and chest pain. Before presentation, the patient received the standard therapy including surgical resection, radiation and TMZ...
October 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Joseph A McBride, Gregory M Gauthier, Bruce S Klein
The causal agents of blastomycosis, Blastomyces dermatitidis and Blastomyces gilchristii, belong to a group of thermally dimorphic fungi that can infect healthy and immunocompromised individuals. Following inhalation of mycelial fragments and spores into the lungs, Blastomyces spp convert into pathogenic yeast and evade host immune defenses to cause pneumonia and disseminated disease. The clinical spectrum of pulmonary blastomycosis is diverse. The diagnosis of blastomycosis requires a high degree of clinical suspicion and involves culture-based and non-culture-based fungal diagnostic tests...
September 2017: Clinics in Chest Medicine
Nagarjun Rao, Sherri J Mann
No abstract text is available yet for this article.
August 9, 2017: Diagnostic Cytopathology
Cody Doberstein, Abass Noor, David Choi, Jacob Smith, Darren Groh, Leonard Mermel, Curtis Doberstein
There have been infrequent reports of isolated central nervous system blastomycosis. We report a case of intracranial epidural abscess secondary to Blastomyces dermatitidis in a patient residing in Rhode Island with a history of remote travel to an endemic area. The clinical, radiographic, and pathologic features of this unique case are reviewed.
2017: Open Forum Infectious Diseases
Samik Banerjee, Timothy P Dooley, Shelley Gilroy, James R Parkinson
Isolated blastomycosis hand infections are extremely rare, and are often clinically unsuspected, leading to delays in clinical diagnosis. Conclusive diagnosis often necessitates fungal cultures and histopathological demonstration of budding yeasts in tissues. In this report, we describe the rare occurrence of isolated blastomycotic hand infection, without any other organ involvement, in a 42-year-old male patient. Analyzing tissue specimens with frozen section has been shown in the past to demonstrate granulomatous inflammation and yeast forms of the organism; however, as demonstrated in this patient, the presence of pseudoepitheliomatous cells may deceptively appear as malignant, causing substantial concern and anxiety...
November 2017: Journal of Hand Surgery
Yogesh Sanghvi, Douglas Somers
Fungal peritonitis is an uncommon complication in peritoneal dialysis patients. We report a case of blastomyces dermatitis peritonitis in a nonimmunocompromised peritoneal dialysis patient, who initially presented with symptoms of lower extremity weakness and altered mental status. Peritoneal blastomycosis is rare condition and not previously reported in end stage renal disease patients on peritoneal dialysis. Fungal peritonitis can present with subtle clinical findings so a high index of suspicion is needed as early detection and treatment may decrease mortality and morbidity...
June 19, 2017: Seminars in Dialysis
Faezeh Talebi-Liasi, Michi M Shinohara
We present a case of tissue invasive Trichophyton rubrum (T. rubrum) histologically mimicking blastomycosis in a patient with kidney transplant on chronic immunosuppression. Invasive dermatophyte infections are rare, and present a diagnostic challenge to the dermatopathologist due to atypical clinical and histopathological presentations.
June 19, 2017: Journal of Cutaneous Pathology
Rachael K Needles
A 7-year-old female golden retriever dog was presented with a 2-week history of coughing and inappetence. Examination, radiographs, and blood analysis showed classic evidence of blastomycosis, confirmed with the MVista EIA urine antigen test. A 2-month course of itraconazole and a course of mirtazapine, meloxicam, furosemide, and tetracycline resulted in a successful outcome.
June 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
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