The importance of skin exam in chronic pulmonary blastomycosis. (2020)

• Record Type: Journal Article
• Authors: G. Caldito, Elena; Ajiboye, Oyintayo; Flores, Estefania; Antia, Camila; Demarais, Patricia
• Is Part Of: IDCases. Volume 20(2020)
• Publication Date: 2020
• Subjects: Blastomycosis -- Cutaneous blastomycosis -- Disseminated blastomycosis -- Pneumonia -- Scalp; Communicable diseases -- Periodicals; Communicable Diseases -- Case Reports; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; 616.9
• DOI: 10.1016/j.idcr.2020.e00812
• Languages: English
• ISSNs: 2214-2509

Abstract

Highlights: -Blastomycosis is a chronic granulomatous disease that usually starts as a pulmonary infection. -A high percentage of patients will develop a disseminated disease if the initial lung infection is left untreated. -Cutaneous blastomycosis is the most common extrapulmonary manifestation. -Definitive diagnosis requires direct visualization of the yeast at staining or positive fungal culture. Abstract: Cutaneous blastomycosis is the most common extrapulmonary manifestation of disseminated blastomycosis, a disease caused by Blastomyces dermatitidis, a dimorphic fungus endemic of North America. Initially, the organism enters the respiratory system by inhalation of the infectious conidia and produces an acute pulmonary infection that may eventually disseminate if it is left untreated. Blastomycosis may represent a diagnostic challenge and its definitive diagnosis requires direct visualization of the distinctive yeast or a positive fungal culture. The objective of this case report is to highlight the importance of the skin exam and tissue biopsy in the diagnosis of blastomycosis. We present a previously healthy patient with chronic pneumonia, evaluated at Pulmonary clinic with non-diagnostic thoracentesis and bronchoscopy, found to have disseminated blastomycosis after biopsy of a scalp lesion in Dermatology clinic.