Disseminated blastomycosis presenting as a retro-orbital mass. Issue 7 (18th July 2019)

• Record Type: Journal Article
• Authors: Murawski, Shannon; Farrell, Michael; Cordeiro-Rudnisky, Fernanda; Blinkhorn, Richard
• Is Part Of: BMJ case reports. Volume 12:Issue 7(2019)
• Publication Date: 2019-07-18
• Subjects: infectious diseases -- TB and other respiratory infections -- ophthalmology -- pathology; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-228681
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : A 43-year-old man with history of non-Hodgkins' lymphoma presented with unilateral eye swelling, pain and vision deficits which had been progressive over 2 months. Symptoms followed a presumed bacterial pneumonia 4 months prior. Imaging demonstrated retro-orbital soft tissue swelling with bony erosion concerning for a mass; surgical decompression was performed with histology confirming disseminated Blastomyces dermatitidis . Symptoms responded rapidly to antifungal therapy with amphotericin followed by itraconazole. Orbital dissemination of blastomycosis is extremely rare; accurate diagnosis requires tissue biopsy to facilitate timely targeted therapy and minimise morbidity.