Unusual osseous presentation of blastomycosis in an immigrant child: a challenge for European pediatricians (original) (raw)
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Blastomycosis acquired by three children in Toronto
The Canadian journal of infectious diseases = Journal canadien des maladies infectieuses, 2002
Three paediatric cases of blastomycosis, apparently acquired in or near Toronto, Ontario, a region not known to be endemic for this disease, are described. Blastomycosis was not suspected clinically in any of the three cases, and the diagnosis was established only when the diagnostic net was broadened to include fungal and mycobacterial cultures. All three patients were diagnosed after significant delays, which is consistent with the rarity of the disease in children and its acquisition outside previously accepted geographical boundaries. Pulmonary involvement was present in all three children, while one also had multifocal osteomyelitis. Drug therapy was successful in all three cases, either with amphotericin B followed by itraconazole, or itraconazole alone. Blastomycosis should be included in the differential diagnosis of a patient from the Toronto area who presents with a compatible history despite a negative travel history to known endemic zones.
Blastomyscosis Acquired by Three Children in Toronto
Canadian Journal of Infectious Diseases, 2002
Three paediatric cases of blastomycosis, apparently acquired in or near Toronto, Ontario, a region not known to be endemic for this disease, are described. Blastomycosis was not suspected clinically in any of the three cases, and the diagnosis was established only when the diagnostic net was broadened to include fungal and mycobacterial cultures. All three patients were diagnosed after significant delays, which is consistent with the rarity of the disease in children and its acquisition outside previously accepted geographical boundaries. Pulmonary involvement was present in all three children, while one also had multifocal osteomyelitis. Drug therapy was successful in all three cases, either with amphotericin B followed by itraconazole, or itraconazole alone. Blastomycosis should be included in the differential diagnosis of a patient from the Toronto area who presents with a compatible history despite a negative travel history to known endemic zones.
Cutaneous blastomycosis: a clue to a systemic disease
Anais Brasileiros de Dermatologia, 2013
A 55-year-old male presented with back pain and slightly tender annular plaques with central ulceration on his face. A skin biopsy revealed scattered yeast with broad based buds. A CT scan of the abdomen revealed a pathologic T12 fracture. Tissue obtained from the spine confirmed budding yeasts. The patient was diagnosed with disseminated blastomycosis. The patient was treated with amphotericin and itraconazole and completely recovered.
American Journal of Clinical Pathology, 2014
Upon completion of this activity you will be able to: • list the geographic localization of Blastomyces infection. • identify the histopathologic features of blastomycosis osteomyelitis. • describe methods for microbiologic confirmation of Blastomyces infection. The ASCP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The ASCP designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit ™ per article. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity qualifies as an American Board of Pathology Maintenance of Certification Part II Self-Assessment Module. The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose. Questions appear on p 724. Exam is located at www.ascp.org/ajcpcme.
Paediatric cutaneous blastomycosis: A rare case diagnosed on FNAC
Diagnostic Cytopathology, 2009
Blastomycosis, usually presenting as pneumonia, is more common in adults than in children. Moreover, cutaneous blastomycosis is quite uncommon in children. We describe a case of cutaneous blastomycosis in an 8-year-old boy who presented with multiple hyperkeratotic verrucous plaques where diagnosis was made on fine-needle aspiration cytology, and the infection responded well to oral itraconazole therapy with reduction in number of spores and size of lesions.
Clinical and Laboratory Update on Blastomycosis
Clinical Microbiology Reviews, 2010
SUMMARY Blastomycosis is endemic in regions of North America that border the Great Lakes and the St. Lawrence River, as well as in the Mississippi River and Ohio River basins. Men are affected more often than women and children because men are more likely to participate in activities that put them at risk for exposure to Blastomyces dermatitidis . Human infection occurs when soil containing microfoci of mycelia is disturbed and airborne conidia are inhaled. If natural defenses in the alveoli fail to contain the infection, lymphohematogenous dissemination ensues. Normal host responses generate a characteristic pyogranulomatous reaction. The most common sites of clinical disease are the lung and skin; osseous, genitourinary, and central nervous system manifestations follow in decreasing order of frequency. Blastomycosis is one of the great mimickers in medicine; verrucous cutaneous blastomycosis resembles malignancy, and mass-like lung opacities due to B. dermatitidis often are confus...
Clinical Infectious Diseases, 1996
less-than-satisfactory response to the oral azole antifungal medications are challenging for the clinician.
Blastomycosis in Children: An Analysis of Clinical, Epidemiologic, and Genetic Features
Journal of the Pediatric Infectious Diseases Society, 2015
Blastomyces spp. are endemic in regions of the United States and result in blastomycosis, a serious and potentially fatal infection. Little is known about the presentation, clinic course, epidemiology, and genetics of blastomycosis in children. A retrospective review of children with blastomycosis confirmed by culture or cytopathology between 1999 and 2014 was completed. Blastomyces sp. isolates were genotyped by using microsatellite typing, and species were typed by sequencing of internal transcribed spacer 2 (its2). Of the 114 children with blastomycosis identified, 79% had isolated pulmonary involvement and 21% had extrapulmonary disease. There were more systemic findings, including fever (P = .01), poor intake (P = .01), elevated white blood cell count (P < .01), and elevated C-reactive protein level (P < .01), in children with isolated pulmonary disease than in children with extrapulmonary disease. Children with extrapulmonary disease had more surgeries (P = .01) and dela...